convenio data_pagamento numero_protocolo matricula nome numero_guia ng_prest senha_guia codigo_produto descricao_produto valor_apresentado valor_pago valor_glosa descricao_motivo codigo_motivo
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12647284040 NULL 12647284040 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1750 0.0050 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 00487 RANITIDINA 25 MG/ML 2 ML SI IM IV AP 0.0000 0.9300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 00487 RANITIDINA 25 MG/ML 2 ML SI IM IV AP 0.0000 0.9300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 00487 RANITIDINA 25 MG/ML 2 ML SI IM IV AP 0.0000 0.9300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 00487 RANITIDINA 25 MG/ML 2 ML SI IM IV AP 0.0000 0.9300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 00406 FUROSEMIDA 10 MG/ML 2 ML SI IM IV AP 0.0000 1.2000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 00406 FUROSEMIDA 10 MG/ML 2 ML SI IM IV AP 0.0000 0.6000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 03280 CLOREXIDINA 2 % ST TP ML 0.0000 0.8000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 14191 OMEPRAZOL 20 MG CA VO UN 0.0000 0.9000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 14191 OMEPRAZOL 20 MG CA VO UN 0.0000 0.9000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 14191 OMEPRAZOL 20 MG CA VO UN 0.0000 0.9000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 24571 CLINDAMICINA 600 MG 4 ML SI IM IV AP 0.0000 13.0800 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 24571 CLINDAMICINA 600 MG 4 ML SI IM IV AP 0.0000 13.0800 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 24571 CLINDAMICINA 600 MG 4 ML SI IM IV AP 0.0000 13.0800 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 24571 CLINDAMICINA 600 MG 4 ML SI IM IV AP 0.0000 13.0800 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 24571 CLINDAMICINA 600 MG 4 ML SI IM IV AP 0.0000 13.0800 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 24571 CLINDAMICINA 600 MG 4 ML SI IM IV AP 0.0000 13.0800 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 24571 CLINDAMICINA 600 MG 4 ML SI IM IV AP 0.0000 13.0800 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 24571 CLINDAMICINA 600 MG 4 ML SI IM IV AP 0.0000 13.0800 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 24571 CLINDAMICINA 600 MG 4 ML SI IM IV AP 0.0000 13.0800 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 24571 CLINDAMICINA 600 MG 4 ML SI IM IV AP 0.0000 13.0800 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 24571 CLINDAMICINA 600 MG 4 ML SI IM IV AP 0.0000 13.0800 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 00172 SORO FISIOLOGICO 0,9% 500 ML SI IV BS 0.0000 9.4698 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 00172 SORO FISIOLOGICO 0,9% 500 ML SI IV BS 0.0000 9.4698 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 081fdadb830fb547e83c43fabdb88372 ELZA 12377335349 NULL 12377335349 09071 ACETILCISTEINA 600MG PO VO SA 0.0000 3.5000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 081fdadb830fb547e83c43fabdb88372 ELZA 12377335349 NULL 12377335349 09071 ACETILCISTEINA 600MG PO VO SA 0.0000 3.5000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 081fdadb830fb547e83c43fabdb88372 ELZA 12377335349 NULL 12377335349 09071 ACETILCISTEINA 600MG PO VO SA 0.0000 3.5000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 081fdadb830fb547e83c43fabdb88372 ELZA 12377335349 NULL 12377335349 09071 ACETILCISTEINA 600MG PO VO SA 0.0000 3.5000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 081fdadb830fb547e83c43fabdb88372 ELZA 12377335349 NULL 12377335349 51240 FITA ADVANTAGE P/ GLICOSE UN 0.0000 5.1800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1771 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1771 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1771 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1771 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.4000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 26981 SORO FISIOLOGICO 0,9% 10 ML SI IV AP 0.0000 0.4800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 26981 SORO FISIOLOGICO 0,9% 10 ML SI IV AP 0.0000 0.4800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 02246 HIDROCORTISONA 100 MG PO IM IV FA 0.0000 2.8300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 02246 HIDROCORTISONA 100 MG PO IM IV FA 0.0000 2.8300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 02246 HIDROCORTISONA 100 MG PO IM IV FA 0.0000 2.8300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 02246 HIDROCORTISONA 100 MG PO IM IV FA 0.0000 2.8300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 02246 HIDROCORTISONA 100 MG PO IM IV FA 0.0000 2.8300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 01611 CLORETO DE POTASSIO 600 MG CA VO UN 0.0000 0.4867 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 01611 CLORETO DE POTASSIO 600 MG CA VO UN 0.0000 0.4864 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4074 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4074 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4074 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4074 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4074 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4074 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4074 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 d17b3c5ae418d82694895a326dee545a ODILIA 12670516743 NULL 12670516743 51219 ALENIA 0.0000 1.1700 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 d17b3c5ae418d82694895a326dee545a ODILIA 12670516743 NULL 12670516743 51208 SORO RINGER SIMPLES 500 ML SI IV BS 0.0000 5.9400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 d17b3c5ae418d82694895a326dee545a ODILIA 12670516743 NULL 12670516743 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 d17b3c5ae418d82694895a326dee545a ODILIA 12670516743 NULL 12670516743 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 d17b3c5ae418d82694895a326dee545a ODILIA 12670516743 NULL 12670516743 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 d17b3c5ae418d82694895a326dee545a ODILIA 12670516743 NULL 12670516743 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 d17b3c5ae418d82694895a326dee545a ODILIA 12670516743 NULL 12670516743 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 d17b3c5ae418d82694895a326dee545a ODILIA 12670516743 NULL 12670516743 02197 METAMUCIL (PLANTAGO OVATA) 3,4 G PO VO EV 0.0000 2.4600 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 d17b3c5ae418d82694895a326dee545a ODILIA 12670516743 NULL 12670516743 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 d17b3c5ae418d82694895a326dee545a ODILIA 12670516743 NULL 12670516743 00128 LUVA DE PROCEDIMENTO UNIDADE UN 0.0000 1.0000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 d17b3c5ae418d82694895a326dee545a ODILIA 12670516743 NULL 12670516743 00128 LUVA DE PROCEDIMENTO UNIDADE UN 0.0000 1.0000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 d17b3c5ae418d82694895a326dee545a ODILIA 12670516743 NULL 12670516743 51230 AGULHA DESC 30 X 7 - 40X12 UN NULL 0.0000 NULL OPME INVALIDO 2201
Glosa Min 2018-10-03 00:00:00.000000 1084117 ea4ad2636c25d8e3dbb569ae62db71e7 IONE 12489788840 NULL 12489788840 00737 CEFTRIAXONA IV 1G + DIL. 10 ML PO IV FA 0.0000 27.0600 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ea4ad2636c25d8e3dbb569ae62db71e7 IONE 12489788840 NULL 12489788840 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ea4ad2636c25d8e3dbb569ae62db71e7 IONE 12489788840 NULL 12489788840 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ea4ad2636c25d8e3dbb569ae62db71e7 IONE 12489788840 NULL 12489788840 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ea4ad2636c25d8e3dbb569ae62db71e7 IONE 12489788840 NULL 12489788840 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.4000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 26981 SORO FISIOLOGICO 0,9% 10 ML SI IV AP 0.0000 0.9600 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 24082 BROMOPRIDA 5 MG/ML 2 ML SI IM IV AP 0.0000 2.7300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 24082 BROMOPRIDA 5 MG/ML 2 ML SI IM IV AP 0.0000 2.7300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 24082 BROMOPRIDA 5 MG/ML 2 ML SI IM IV AP 0.0000 2.7300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00189 GLICONATO DE CALCIO 100 MG/ML10ML SI IV AP 0.0000 1.4500 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00171 SORO FISIOLOGICO 0,9% 250 ML SI IV BS 0.0000 3.9400 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00169 SORO GLICOSADO 5% 500 ML SI IV BS 0.0000 3.6715 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 01584 NEOSTIGMINA 0,5 MG/ML 1 ML SI IM IV SC AP 0.0000 2.3000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 01584 NEOSTIGMINA 0,5 MG/ML 1 ML SI IM IV SC AP 0.0000 0.7662 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 01584 NEOSTIGMINA 0,5 MG/ML 1 ML SI IM IV SC AP 0.0000 0.7656 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 01496 FENITOINA 50 MG/ML 5 ML SI IM IV AP 0.0000 2.3400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 01496 FENITOINA 50 MG/ML 5 ML SI IM IV AP 0.0000 2.3400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 01496 FENITOINA 50 MG/ML 5 ML SI IM IV AP 0.0000 2.3400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 01496 FENITOINA 50 MG/ML 5 ML SI IM IV AP 0.0000 2.3400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00128 LUVA DE PROCEDIMENTO UNIDADE UN 0.0000 1.6700 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00124 LUVA CIRURGICA UN 0.0000 1.4478 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00124 LUVA CIRURGICA UN 0.0000 1.4478 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 53945 ACIDO ASCORBICO 500 MG CP VO UN 0.0000 0.5900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 53945 ACIDO ASCORBICO 500 MG CP VO UN 0.0000 0.5900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6874 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6874 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 52392 SONDA DE ASPIRAÇAO TRAQUEAL C/ VALVULA UN 0.0000 0.9352 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 52392 SONDA DE ASPIRAÇAO TRAQUEAL C/ VALVULA UN 0.0000 0.9352 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 52392 SONDA DE ASPIRAÇAO TRAQUEAL C/ VALVULA UN 0.0000 0.9352 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 52392 SONDA DE ASPIRAÇAO TRAQUEAL C/ VALVULA UN 0.0000 0.9352 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 51649 ALCOOL ETILICO 70 % ST TP ML 0.0000 0.0300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 51649 ALCOOL ETILICO 70 % ST TP ML 0.0000 0.0300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 51241 AGULHA 123X45 0.0000 0.1900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 51241 AGULHA 123X45 0.0000 0.1900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1752 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1752 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1752 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.4000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 35382 COMPRESSAS DE GASES 7.5 X7,5 (11 FIOS ESTERIL) UN 0.0000 0.0600 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 00128 LUVA DE PROCEDIMENTO UNIDADE UN 0.0000 1.6700 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 00124 LUVA CIRURGICA UN 0.0000 1.4500 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 00124 LUVA CIRURGICA UN 0.0000 1.4482 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 00124 LUVA CIRURGICA UN 0.0000 1.4482 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 00124 LUVA CIRURGICA UN 0.0000 1.4482 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 00124 LUVA CIRURGICA UN 0.0000 1.4482 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 00124 LUVA CIRURGICA UN 0.0000 1.4500 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 00124 LUVA CIRURGICA UN 0.0000 1.4500 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 00091 SERINGA DESC 01 ML (INSULINA) UN 0.0000 0.3050 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 00090 SERINGA DESC 20 ML UN 0.0000 0.5367 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 51584 ESPARADRAPO MICROPORE 0.0000 0.2600 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 51584 ESPARADRAPO MICROPORE 0.0000 0.2600 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 51584 ESPARADRAPO MICROPORE 0.0000 0.2600 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 51584 ESPARADRAPO MICROPORE 0.0000 0.2600 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 35382 COMPRESSAS DE GASES 7.5 X7,5 (11 FIOS ESTERIL) UN 0.0000 0.3000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 25040014 Fisioterapia Respiratória - em Doente Clínico Internado 0.0000 10.0600 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 00124 LUVA CIRURGICA UN 0.0000 1.4476 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 00124 LUVA CIRURGICA UN 0.0000 1.4476 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 00124 LUVA CIRURGICA UN 0.0000 1.4476 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 00090 SERINGA DESC 20 ML UN 0.0000 0.5376 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 00090 SERINGA DESC 20 ML UN 0.0000 0.5376 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 00090 SERINGA DESC 20 ML UN 0.0000 0.5376 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1775 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1775 NULL VALOR APRESENTADO A MAIOR 1705
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1775 NULL VALOR APRESENTADO A MAIOR 1705
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1775 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1775 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1775 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1775 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1775 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1775 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 51219 ALENIA 0.0000 1.1700 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.8089 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 000501 OXIGENIO 0.0000 948.0711 NULL COBRANCA DE GASES INCOMPATIVEL COM O UTILIZADO/ PRESCRITO 2310
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 29020166 Nebulização Simples com Broncodilatador 0.0000 7.0200 NULL EXAME NAO AUTORIZADO 2707
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 25040014 Fisioterapia Respiratória - em Doente Clínico Internado 0.0000 5.0300 NULL EXAME NAO AUTORIZADO 2707
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 02246 HIDROCORTISONA 100 MG PO IM IV FA 0.0000 5.6697 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 02246 HIDROCORTISONA 100 MG PO IM IV FA 0.0000 5.6697 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 02246 HIDROCORTISONA 100 MG PO IM IV FA 0.0000 5.6697 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 00182 SULFATO DE MAGNESIO 500 MG/ML 10 ML SI IM IV AP 0.0000 1.3600 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 01611 CLORETO DE POTASSIO 600 MG CA VO UN 0.0000 0.4867 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4074 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 00124 LUVA CIRURGICA UN 0.0000 1.4473 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 00124 LUVA CIRURGICA UN 0.0000 1.4473 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 00124 LUVA CIRURGICA UN 0.0000 1.4500 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00090 SERINGA DESC 20 ML UN 0.0000 0.5387 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00090 SERINGA DESC 20 ML UN 0.0000 0.5387 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00090 SERINGA DESC 20 ML UN 0.0000 0.5387 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00090 SERINGA DESC 20 ML UN 0.0000 0.5387 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00090 SERINGA DESC 20 ML UN 0.0000 0.5387 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00090 SERINGA DESC 20 ML UN 0.0000 0.5387 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00090 SERINGA DESC 20 ML UN 0.0000 0.5387 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00090 SERINGA DESC 20 ML UN 0.0000 0.5387 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00090 SERINGA DESC 20 ML UN 0.0000 0.5387 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00090 SERINGA DESC 20 ML UN 0.0000 0.5387 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00090 SERINGA DESC 20 ML UN 0.0000 0.5387 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00090 SERINGA DESC 20 ML UN 0.0000 0.5387 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00090 SERINGA DESC 20 ML UN 0.0000 0.5387 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00090 SERINGA DESC 20 ML UN 0.0000 0.5387 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1766 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1766 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1766 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1766 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1766 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4088 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4088 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4088 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4088 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4088 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4088 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00943 EQUIPO POLIFIX 2 VIAS UN 0.0000 2.5500 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00090 SERINGA DESC 20 ML UN 0.0000 0.5400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 24082 BROMOPRIDA 5 MG/ML 2 ML SI IM IV AP 0.0000 2.7300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 24082 BROMOPRIDA 5 MG/ML 2 ML SI IM IV AP 0.0000 2.7300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 24082 BROMOPRIDA 5 MG/ML 2 ML SI IM IV AP 0.0000 2.7300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 24082 BROMOPRIDA 5 MG/ML 2 ML SI IM IV AP 0.0000 2.7300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 24082 BROMOPRIDA 5 MG/ML 2 ML SI IM IV AP 0.0000 2.7300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 24082 BROMOPRIDA 5 MG/ML 2 ML SI IM IV AP 0.0000 2.7300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00170 SORO GLICOSADO 5% 250 ML SI IV BS 0.0000 3.4000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 01584 NEOSTIGMINA 0,5 MG/ML 1 ML SI IM IV SC AP 0.0000 0.7667 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 01584 NEOSTIGMINA 0,5 MG/ML 1 ML SI IM IV SC AP 0.0000 0.7667 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 01584 NEOSTIGMINA 0,5 MG/ML 1 ML SI IM IV SC AP 0.0000 0.7667 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 01584 NEOSTIGMINA 0,5 MG/ML 1 ML SI IM IV SC AP 0.0000 0.7667 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 01584 NEOSTIGMINA 0,5 MG/ML 1 ML SI IM IV SC AP 0.0000 0.7667 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4062 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4062 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4062 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4062 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4062 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4062 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4062 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4062 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4062 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4062 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00124 LUVA CIRURGICA UN 0.0000 1.4475 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00124 LUVA CIRURGICA UN 0.0000 1.4475 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00124 LUVA CIRURGICA UN 0.0000 1.4475 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00091 SERINGA DESC 01 ML (INSULINA) UN 0.0000 0.3057 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 09071 ACETILCISTEINA 600MG PO VO SA 0.0000 3.4950 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 09071 ACETILCISTEINA 600MG PO VO SA 0.0000 3.4950 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 07802 PIPERACILINA 4 G + TAZOBACTAM 500 MG PO IV FA 0.0000 0.0000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 07802 PIPERACILINA 4 G + TAZOBACTAM 500 MG PO IV FA 0.0000 0.0000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 07802 PIPERACILINA 4 G + TAZOBACTAM 500 MG PO IV FA 0.0000 83.4500 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00613 CLINDAMICINA 600 MG 4 ML SI IM IV AP 0.0000 13.0800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00613 CLINDAMICINA 600 MG 4 ML SI IM IV AP 0.0000 13.0800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.0000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 26981 SORO FISIOLOGICO 0,9% 10 ML SI IV AP 0.0000 0.0000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 02358 CLORETO DE SODIO 17,55% 10 ML SI IV AP 0.0000 1.1200 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 02246 HIDROCORTISONA 100 MG PO IM IV FA 0.0000 2.8300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00171 SORO FISIOLOGICO 0,9% 250 ML SI IV BS 0.0000 3.9400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00171 SORO FISIOLOGICO 0,9% 250 ML SI IV BS 0.0000 3.9400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 01611 CLORETO DE POTASSIO 600 MG CA VO UN 0.0000 0.0000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 0.0000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 05975 COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER 0.7739 0.8059 -0.7759 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 11193 CLOREXIDINA 2 % ST TP ML 0.5300 0.5320 -0.0020 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 11193 CLOREXIDINA 2 % ST TP ML 0.5300 0.5320 -0.0020 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 11193 CLOREXIDINA 2 % ST TP ML 0.5300 0.5320 -0.0020 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00817 ALGODAO HIDROFILO BOLINHA UN 0.2600 0.2860 -0.0260 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 07269 DIPIRONA 500 MG/ML 2 ML SI IV IM AP 0.6900 0.6860 0.0040 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 07269 DIPIRONA 500 MG/ML 2 ML SI IV IM AP 0.6900 0.6860 0.0040 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 19151 SERINGA DESC 10 ML UN 0.3300 0.6669 -0.3369 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 19151 SERINGA DESC 10 ML UN 0.3300 0.6669 -0.3369 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 31585 RANITIDINA 25 MG/ML 2 ML SI IV IM AP 0.9300 0.9334 -0.0034 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 31585 RANITIDINA 25 MG/ML 2 ML SI IV IM AP 0.9300 0.9334 -0.0034 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 31585 RANITIDINA 25 MG/ML 2 ML SI IV IM AP 0.9300 0.9334 -0.0034 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 31585 RANITIDINA 25 MG/ML 2 ML SI IV IM AP 0.9300 1.8668 -0.9368 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 19445 CLORETO DE POTASSIO 600 MG CA VO UN 0.9768 1.4605 -0.9705 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 19445 CLORETO DE POTASSIO 600 MG CA VO UN 0.9768 1.4605 -0.9705 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 19445 CLORETO DE POTASSIO 600 MG CA VO UN 1.4637 1.9474 -1.4574 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 19160 SERINGA DESC 20 ML UN 0.5400 0.5374 0.0026 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 27596 TIRA TESTE PARA GLICOSE UN 1.0400 1.0400 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 27596 TIRA TESTE PARA GLICOSE UN 1.0400 2.0800 -1.0400 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 34827 TIORFAN (RACECADOTRILA) 100 MG CA VO UN 3.2000 3.2000 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 34827 TIORFAN (RACECADOTRILA) 100 MG CA VO UN 3.2000 6.4000 -3.2000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1060 -0.0060 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1060 -0.0060 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1060 -0.0060 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1060 -0.0060 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.2120 -0.1120 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.2120 -0.1120 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 19151 SERINGA DESC 10 ML UN 0.3300 0.0000 0.3300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 34789 SONDA ASPIRAÇAO C/ VALVULA - TODAS - UTI UN 0.9400 0.9367 0.0033 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 51162 AGUA BIDESTILADA 10 ML SI IM IV AP NULL 0.0000 NULL OPME INVALIDO 2201
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN NULL 0.0000 NULL OPME INVALIDO 2201
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 000501 OXIGENIO NULL 0.0000 NULL OPME INVALIDO 2201
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 27060039 Unidade de Plasma NULL 0.0000 NULL OPME INVALIDO 2201
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1770 0.0030 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1770 0.0030 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1770 0.0030 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1770 0.0030 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1770 0.0030 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1770 0.0030 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1770 0.0030 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1770 0.0030 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1770 0.0030 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1760 0.0040 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 33227 LUVA CIRURGICA PAR UN 1.4500 1.4476 0.0024 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 33227 LUVA CIRURGICA PAR UN 1.4500 1.4476 0.0024 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 33227 LUVA CIRURGICA PAR UN 1.4500 1.4476 0.0024 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 33227 LUVA CIRURGICA PAR UN 1.4500 1.4476 0.0024 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 05975 COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER 0.3000 0.0000 0.3000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12662414945 NULL 12662414945 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4071 0.0029 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12662414945 NULL 12662414945 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4071 0.0029 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12662414945 NULL 12662414945 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4071 0.0029 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12662414945 NULL 12662414945 42358 FUROSEMIDA 10 MG/ML 2 ML SI IM IV AP 1.2000 1.1967 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12662414945 NULL 12662414945 13404 OMEPRAZOL 40 MG + DIL. 10 ML PO IV FA 19.5800 19.5750 0.0050 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12662414945 NULL 12662414945 19160 SERINGA DESC 20 ML UN 0.5400 0.5367 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12662414945 NULL 12662414945 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1750 0.0050 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12647284040 NULL 12647284040 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4086 0.0014 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 05975 COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER 0.3000 0.0000 0.3000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 27596 TIRA TESTE PARA GLICOSE UN 1.0400 1.0400 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 27596 TIRA TESTE PARA GLICOSE UN 1.0400 1.0400 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 27596 TIRA TESTE PARA GLICOSE UN 1.0400 1.0400 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 37761 ALCOOL ETILICO 70 % ST TP ML 0.0600 0.0000 0.0600 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 52353 ABAIXADOR DE LINGUA UN 0.0500 0.0267 0.0233 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 37761 ALCOOL ETILICO 70 % ST TP ML 0.0300 0.0000 0.0300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 00817 ALGODAO HIDROFILO BOLINHA UN 0.5100 0.0000 0.5100 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 37761 ALCOOL ETILICO 70 % ST TP ML 0.0600 0.0000 0.0600 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 0111beed375944f60c7ad4a7fd4874f8 WALDIR 12746025744 NULL 12746025744 19160 SERINGA DESC 20 ML UN 0.5400 0.5379 0.0021 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 0111beed375944f60c7ad4a7fd4874f8 WALDIR 12746025744 NULL 12746025744 19160 SERINGA DESC 20 ML UN 0.5400 0.5379 0.0021 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 0111beed375944f60c7ad4a7fd4874f8 WALDIR 12746025744 NULL 12746025744 19160 SERINGA DESC 20 ML UN 0.5400 0.5383 0.0017 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 0111beed375944f60c7ad4a7fd4874f8 WALDIR 12746025744 NULL 12746025744 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4076 0.0024 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 0111beed375944f60c7ad4a7fd4874f8 WALDIR 12746025744 NULL 12746025744 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 1.6200 1.6147 0.0053 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 0111beed375944f60c7ad4a7fd4874f8 WALDIR 12746025744 NULL 12746025744 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8074 0.0026 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4070 0.0030 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 05975 COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER 0.0600 0.0000 0.0600 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 05975 COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER 0.0300 0.0001 0.0299 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 32204 CLORETO DE SODIO 0,9% 10 ML SI IV AP 0.9600 0.9600 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 32204 CLORETO DE SODIO 0,9% 10 ML SI IV AP 0.4800 0.0000 0.4800 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 8a5ecfde671848d05ac757e0112e689c TEREZINHA 12700337042 NULL 12700337042 19160 SERINGA DESC 20 ML UN 0.5400 0.5376 0.0024 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 8a5ecfde671848d05ac757e0112e689c TEREZINHA 12700337042 NULL 12700337042 19160 SERINGA DESC 20 ML UN 0.5400 0.5376 0.0024 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 8a5ecfde671848d05ac757e0112e689c TEREZINHA 12700337042 NULL 12700337042 19160 SERINGA DESC 20 ML UN 0.5400 0.5376 0.0024 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 8a5ecfde671848d05ac757e0112e689c TEREZINHA 12700337042 NULL 12700337042 19160 SERINGA DESC 20 ML UN 0.5400 0.5376 0.0024 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 8a5ecfde671848d05ac757e0112e689c TEREZINHA 12700337042 NULL 12700337042 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4071 0.0029 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 8a5ecfde671848d05ac757e0112e689c TEREZINHA 12700337042 NULL 12700337042 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4071 0.0029 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 8a5ecfde671848d05ac757e0112e689c TEREZINHA 12700337042 NULL 12700337042 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4071 0.0029 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 8a5ecfde671848d05ac757e0112e689c TEREZINHA 12700337042 NULL 12700337042 57258 FUMARATO DE QUETIAPINA 25 MG CA VO UN 1.2500 1.2450 0.0050 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 8a5ecfde671848d05ac757e0112e689c TEREZINHA 12700337042 NULL 12700337042 57258 FUMARATO DE QUETIAPINA 25 MG CA VO UN 1.2500 1.2450 0.0050 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 8a5ecfde671848d05ac757e0112e689c TEREZINHA 12700337042 NULL 12700337042 09733 ACETILCISTEINA 600MG PO VO SA 3.5000 3.4967 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 8a5ecfde671848d05ac757e0112e689c TEREZINHA 12700337042 NULL 12700337042 09733 ACETILCISTEINA 600MG PO VO SA 3.5000 3.4967 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 8a5ecfde671848d05ac757e0112e689c TEREZINHA 12700337042 NULL 12700337042 10626 GLICOSE 50% 10 ML SI IV AP 2.7400 2.7350 0.0050 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 1.6200 1.6154 0.0046 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1766 0.0034 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1766 0.0034 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1766 0.0034 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1766 0.0034 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 d17b3c5ae418d82694895a326dee545a ODILIA 12670516743 NULL 12670516743 00817 ALGODAO HIDROFILO BOLINHA UN 0.1300 0.1300 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 d17b3c5ae418d82694895a326dee545a ODILIA 12670516743 NULL 12670516743 30376 BROMETO DE IPRATROPIO 0,25MG/ML SL IN GT 0.4000 0.0000 0.4000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cd2840524be5a3f1d0939f241e24f32b MARIA 12705908340 NULL 12705908340 02461 FENOTEROL 2 MG/ML 10 ML AE IN DS 0.4300 0.0000 0.4300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cd2840524be5a3f1d0939f241e24f32b MARIA 12705908340 NULL 12705908340 30376 BROMETO DE IPRATROPIO 0,25MG/ML SL IN GT 0.4000 0.0000 0.4000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cd2840524be5a3f1d0939f241e24f32b MARIA 12705908340 NULL 12705908340 30376 BROMETO DE IPRATROPIO 0,25MG/ML SL IN GT 0.4000 0.0000 0.4000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cd2840524be5a3f1d0939f241e24f32b MARIA 12705908340 NULL 12705908340 32204 CLORETO DE SODIO 0,9% 10 ML SI IV AP 0.4800 0.4800 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 08664 ESPARADRAPO MICROPORE 50 X 10 CM CM 0.7700 0.7670 0.0030 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 08664 ESPARADRAPO MICROPORE 50 X 10 CM CM 0.7700 0.7670 0.0030 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1772 0.0028 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1772 0.0028 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1772 0.0028 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1772 0.0028 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.2100 0.2057 0.0043 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 19151 SERINGA DESC 10 ML UN 0.6700 0.6657 0.0043 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 19151 SERINGA DESC 10 ML UN 0.6700 0.6657 0.0043 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00817 ALGODAO HIDROFILO BOLINHA UN 0.1000 0.0000 0.1000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 08664 ESPARADRAPO MICROPORE 50 X 10 CM CM 0.7700 0.2550 0.5150 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 53660 EQUIPO MACRO-GOTAS FLEXIVEL C/ INJETOR LATE 1.5900 0.0000 1.5900 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4061 0.0039 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4061 0.0039 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4061 0.0039 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4061 0.0039 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4061 0.0039 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4061 0.0039 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4061 0.0039 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4061 0.0039 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4061 0.0039 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4061 0.0039 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 42358 FUROSEMIDA 10 MG/ML 2 ML SI IM IV AP 1.2000 1.1964 0.0036 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 42358 FUROSEMIDA 10 MG/ML 2 ML SI IM IV AP 1.2000 1.1960 0.0040 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 33537 PIPERACILINA 2 G + TAZOBACTAM 250 MG 30 ML 55.3400 55.3375 0.0025 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 33537 PIPERACILINA 2 G + TAZOBACTAM 250 MG 30 ML 55.3400 55.3375 0.0025 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 33537 PIPERACILINA 2 G + TAZOBACTAM 250 MG 30 ML 55.3400 55.3375 0.0025 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 11193 CLOREXIDINA 2 % ST TP ML 0.5300 0.5300 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 05975 COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER 0.3000 0.0000 0.3000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 05975 COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER 0.3000 0.0000 0.3000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 11193 CLOREXIDINA 2 % ST TP ML 0.2700 0.0000 0.2700 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e715e2ae28a6229c8609756d3298bf52 MARIA 12734221144 NULL 12734221144 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1750 0.0050 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 33219 LUVA DE PROCEDIMENTO UNIDADE UN 1.0000 0.6700 0.3300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 32204 CLORETO DE SODIO 0,9% 10 ML SI IV AP 0.9600 0.0000 0.9600 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 32204 CLORETO DE SODIO 0,9% 10 ML SI IV AP 0.4800 0.0000 0.4800 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 32204 CLORETO DE SODIO 0,9% 10 ML SI IV AP 0.4800 0.0000 0.4800 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 32204 CLORETO DE SODIO 0,9% 10 ML SI IV AP 0.4800 0.0000 0.4800 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4088 0.0012 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8067 0.0033 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8067 0.0033 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 30376 BROMETO DE IPRATROPIO 0,25MG/ML SL IN GT 0.6000 0.0000 0.6000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 30376 BROMETO DE IPRATROPIO 0,25MG/ML SL IN GT 0.6000 0.0000 0.6000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 32204 CLORETO DE SODIO 0,9% 10 ML SI IV AP 0.4800 0.0000 0.4800 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 32204 CLORETO DE SODIO 0,9% 10 ML SI IV AP 0.4800 0.4800 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 32204 CLORETO DE SODIO 0,9% 10 ML SI IV AP 0.4800 0.0000 0.4800 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 02461 FENOTEROL 2 MG/ML 10 ML AE IN DS 0.3400 0.0000 0.3400 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 32204 CLORETO DE SODIO 0,9% 10 ML SI IV AP 0.4800 0.0000 0.4800 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4074 0.0026 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1036 -0.0036 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4084 0.0016 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4084 0.0016 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4084 0.0016 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4084 0.0016 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4084 0.0016 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 05975 COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER 0.6000 0.3833 0.2167 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 05975 COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER 0.3000 0.0000 0.3000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 53660 EQUIPO MACRO-GOTAS FLEXIVEL C/ INJETOR LATE 1.5900 0.0000 1.5900 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1900 0.1900 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1900 0.1900 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 b288bbcfb9aecab51bcb0dba62ca0059 IVONETE 12743730847 NULL 12743730847 19160 SERINGA DESC 20 ML UN 0.5400 0.5367 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 b288bbcfb9aecab51bcb0dba62ca0059 IVONETE 12743730847 NULL 12743730847 19160 SERINGA DESC 20 ML UN 0.5400 0.5367 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 b288bbcfb9aecab51bcb0dba62ca0059 IVONETE 12743730847 NULL 12743730847 19160 SERINGA DESC 20 ML UN 0.5400 0.5367 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 b288bbcfb9aecab51bcb0dba62ca0059 IVONETE 12743730847 NULL 12743730847 19160 SERINGA DESC 20 ML UN 0.5400 0.5367 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 b288bbcfb9aecab51bcb0dba62ca0059 IVONETE 12743730847 NULL 12743730847 19160 SERINGA DESC 20 ML UN 0.5400 0.5367 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 b288bbcfb9aecab51bcb0dba62ca0059 IVONETE 12743730847 NULL 12743730847 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4067 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1038 -0.0038 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1038 -0.0038 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 33227 LUVA CIRURGICA PAR UN 1.4500 1.4476 0.0024 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 33227 LUVA CIRURGICA PAR UN 1.4500 1.4476 0.0024 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 33227 LUVA CIRURGICA PAR UN 1.4500 1.4476 0.0024 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 33227 LUVA CIRURGICA PAR UN 1.4500 1.4476 0.0024 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 33227 LUVA CIRURGICA PAR UN 1.4500 1.4476 0.0024 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 33227 LUVA CIRURGICA PAR UN 1.4500 1.4476 0.0024 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4078 0.0022 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4078 0.0022 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4078 0.0022 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4078 0.0022 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 42358 FUROSEMIDA 10 MG/ML 2 ML SI IM IV AP 0.6000 0.5986 0.0014 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 58661 ENCRISE (ARGIPRESSINA) 20 U/ML 1 ML SI SC 40.2400 40.2343 0.0057 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 37761 ALCOOL ETILICO 70 % ST TP ML 0.0200 0.0150 0.0050 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 08664 ESPARADRAPO MICROPORE 50 X 10 CM CM 0.7700 0.7682 0.0018 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 08664 ESPARADRAPO MICROPORE 50 X 10 CM CM 0.2600 0.2561 0.0039 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4074 0.0026 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 09733 ACETILCISTEINA 600MG PO VO SA 3.5000 3.4955 0.0045 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 09733 ACETILCISTEINA 600MG PO VO SA 3.5000 3.4955 0.0045 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 09733 ACETILCISTEINA 600MG PO VO SA 3.5000 3.4955 0.0045 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 09733 ACETILCISTEINA 600MG PO VO SA 3.5000 3.4955 0.0045 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 09733 ACETILCISTEINA 600MG PO VO SA 3.5000 3.4955 0.0045 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 09733 ACETILCISTEINA 600MG PO VO SA 3.5000 3.4955 0.0045 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8072 0.0028 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8072 0.0028 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8072 0.0028 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8072 0.0028 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8072 0.0028 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8072 0.0028 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1770 0.0030 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1770 0.0030 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1770 0.0030 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1770 0.0030 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1770 0.0030 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1770 0.0030 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1770 0.0030 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1770 0.0030 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 de1a8276d878171456d7fc8f6dcd2457 ABEL 12764206443 NULL 12764206443 07269 DIPIRONA 500 MG/ML 2 ML SI IV IM AP 0.6900 0.6867 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 01081197 077051bf3e8309e603928bbc982a522c KARLA 12660344627 NULL 12660344627 20010010 ECG - ELETROCARDIOGRAMA 0.0000 11.5710 NULL ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 ea6abb4182a48f0934f3e9eb5affa056 DILVA 12697455440 NULL 12697455440 29020166 NEBULIZACAO SIMPLES COM BRONCODILAT 0.0000 26.9300 NULL ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 01081195 a6786839bc6f6afb2125c1877c91c932 MARIA 12742490110 NULL 12742490110 00010014 CONSULTA EM CONSULTORIO MEDICO 0.0000 35.0000 NULL ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 32891 EQUIPO POLIFIX 2ş VIAS UN 7.6500 2.5500 5.1000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 4668d2494ed6c4b2d18be299efcb26a2 JOAO 12469689344 NULL 12469689344 05975 COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER 0.0300 0.0000 0.0300 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 cb57fc8e673b7c8bc339e1fe25d70cd5 HELIO 12661165148 NULL 12661165148 07269 DIPIRONA 500 MG/ML 2 ML SI IV IM AP 0.6900 0.6867 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 cb57fc8e673b7c8bc339e1fe25d70cd5 HELIO 12661165148 NULL 12661165148 07269 DIPIRONA 500 MG/ML 2 ML SI IV IM AP 0.6900 0.6867 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 39df67956a358bf1eab89803158d25dd HELENA 12655863342 NULL 12655863342 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1750 0.0050 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 39df67956a358bf1eab89803158d25dd HELENA 12655863342 NULL 12655863342 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1750 0.0050 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 39df67956a358bf1eab89803158d25dd HELENA 12655863342 NULL 12655863342 27480 CLARITROMICINA 500 MG 30 ML PO IV FA 117.1100 117.1050 0.0050 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 39df67956a358bf1eab89803158d25dd HELENA 12655863342 NULL 12655863342 00817 ALGODAO HIDROFILO BOLINHA UN 0.1300 0.1200 0.0000 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 edffb7fef608512400078fdf75991573 CARLA 12728631049 NULL 12728631049 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1760 0.0040 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 a050ed50115d2a6dd0b15b99b39063da ARI 12676101147 NULL 12676101147 19160 SERINGA DESC 20 ML UN 0.5400 0.5367 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 a050ed50115d2a6dd0b15b99b39063da ARI 12676101147 NULL 12676101147 19160 SERINGA DESC 20 ML UN 0.5400 0.5364 0.0036 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 33219 LUVA DE PROCEDIMENTO UNIDADE UN 1.0000 0.6700 0.3300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 818a6f2e549cc6a60aa20f9d0595eec9 ANTONIO 12565134343 NULL 12565134343 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1767 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 818a6f2e549cc6a60aa20f9d0595eec9 ANTONIO 12565134343 NULL 12565134343 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1767 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 818a6f2e549cc6a60aa20f9d0595eec9 ANTONIO 12565134343 NULL 12565134343 19160 SERINGA DESC 20 ML UN 0.5400 0.5371 0.0029 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 818a6f2e549cc6a60aa20f9d0595eec9 ANTONIO 12565134343 NULL 12565134343 19160 SERINGA DESC 20 ML UN 0.5400 0.5371 0.0029 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 818a6f2e549cc6a60aa20f9d0595eec9 ANTONIO 12565134343 NULL 12565134343 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4000 0.0000 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 edffb7fef608512400078fdf75991573 CARLA 12728631049 NULL 12728631049 000435 TAXA DE RESPIRADOR A VOLUME (MAI) 0.0000 0.0000 NULL ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 19151 SERINGA DESC 10 ML UN 0.3300 0.0000 0.3300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.0000 0.1000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 08648 ESPARADRAPO 10 X 4.5 CM CM 0.4000 0.2000 0.2000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 02461 FENOTEROL 2 MG/ML 10 ML AE IN DS 2.5500 0.0000 2.5500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 08648 ESPARADRAPO 10 X 4.5 CM CM 0.4000 0.2000 0.2000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12603877940 NULL 12603877940 37761 ALCOOL ETILICO 70 % ST TP ML 0.0300 0.0200 0.0100 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12603877940 NULL 12603877940 55018 ALGINATO DE CALCIO EM HIDROGEL GL TP GR 17.2500 13.8000 3.4500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12603877940 NULL 12603877940 13757 IODOPOVIDONA SD TP ML 0.4000 0.0000 0.4000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12603877940 NULL 12603877940 00817 ALGODAO HIDROFILO BOLINHA UN 0.2600 0.1300 0.1300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12603877940 NULL 12603877940 06343 CLINDAMICINA 600 MG 4 ML SI IM IV AP 39.2400 0.0000 39.2400 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cd2840524be5a3f1d0939f241e24f32b MARIA 12705908340 NULL 12705908340 52582 CATETER OXIGENIO TIPO OCULOS UN 1.0000 0.0000 1.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cd2840524be5a3f1d0939f241e24f32b MARIA 12705908340 NULL 12705908340 00817 ALGODAO HIDROFILO BOLINHA UN 0.2600 0.1300 0.1300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cd2840524be5a3f1d0939f241e24f32b MARIA 12705908340 NULL 12705908340 37761 ALCOOL ETILICO 70 % ST TP ML 0.0300 0.0200 0.0100 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cd2840524be5a3f1d0939f241e24f32b MARIA 12705908340 NULL 12705908340 00817 ALGODAO HIDROFILO BOLINHA UN 0.2600 0.1300 0.1300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cd2840524be5a3f1d0939f241e24f32b MARIA 12705908340 NULL 12705908340 00817 ALGODAO HIDROFILO BOLINHA UN 0.2600 0.1300 0.1300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cd2840524be5a3f1d0939f241e24f32b MARIA 12705908340 NULL 12705908340 33219 LUVA DE PROCEDIMENTO UNIDADE UN 1.0000 0.6700 0.3300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cd2840524be5a3f1d0939f241e24f32b MARIA 12705908340 NULL 12705908340 00817 ALGODAO HIDROFILO BOLINHA UN 0.2600 0.1300 0.1300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 11134 HEPARINA 5000 UI/ML 5 ML SI IV SC ML 14.4000 2.8800 11.5200 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 14370 FIO MONONYLON 3-0 C/ AGULHA 2,4 3/8 163T E 13.3700 0.0000 13.3700 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 01724 ATADURA CREPOM 10 CM UN 0.7900 0.0000 0.7900 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.0000 0.1800 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 14664 NALOXONA 0,4 MG/ML 1 ML SI IM IV SC AP 7.4200 0.0000 7.4200 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 33219 LUVA DE PROCEDIMENTO UNIDADE UN 1.0000 0.6700 0.3300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 37761 ALCOOL ETILICO 70 % ST TP ML 0.0600 0.0300 0.0300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 37761 ALCOOL ETILICO 70 % ST TP ML 0.0600 0.0300 0.0300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 d4089ccef13567fd45b16fb0b60685fa VERA 12656425943 NULL 12656425943 33219 LUVA DE PROCEDIMENTO UNIDADE UN 1.0000 0.0000 1.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 d4089ccef13567fd45b16fb0b60685fa VERA 12656425943 NULL 12656425943 33219 LUVA DE PROCEDIMENTO UNIDADE UN 1.6700 0.6700 1.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 d4089ccef13567fd45b16fb0b60685fa VERA 12656425943 NULL 12656425943 33219 LUVA DE PROCEDIMENTO UNIDADE UN 0.6700 0.0000 0.6700 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 5f044434edae42d3d17c4392018c7824 DINORA 12673932742 NULL 12673932742 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.0000 0.1000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 37761 ALCOOL ETILICO 70 % ST TP ML 0.0300 0.0200 0.0100 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 33219 LUVA DE PROCEDIMENTO UNIDADE UN 1.0000 0.6700 0.3300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 37761 ALCOOL ETILICO 70 % ST TP ML 0.0300 0.0200 0.0100 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 00817 ALGODAO HIDROFILO BOLINHA UN 0.2600 0.1300 0.1300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 00817 ALGODAO HIDROFILO BOLINHA UN 0.2600 0.1300 0.1300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 37761 ALCOOL ETILICO 70 % ST TP ML 0.0300 0.0200 0.0100 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 37761 ALCOOL ETILICO 70 % ST TP ML 0.0300 0.0200 0.0100 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 33219 LUVA DE PROCEDIMENTO UNIDADE UN 1.0000 0.6700 0.3300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 37761 ALCOOL ETILICO 70 % ST TP ML 0.0300 0.0200 0.0100 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 f15dde67c6bce10519b3c6376759939c JOAO 12625226846 NULL 12625226846 08664 ESPARADRAPO MICROPORE 50 X 10 CM CM 2.5600 1.0200 1.5400 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 33219 LUVA DE PROCEDIMENTO UNIDADE UN 1.0000 0.6700 0.3300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 00817 ALGODAO HIDROFILO BOLINHA UN 0.2600 0.1300 0.1300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 53660 EQUIPO MACRO-GOTAS FLEXIVEL C/ INJETOR LATE 1.5900 0.0000 1.5900 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 33219 LUVA DE PROCEDIMENTO UNIDADE UN 1.0000 0.6700 0.3300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 37761 ALCOOL ETILICO 70 % ST TP ML 0.0600 0.0300 0.0300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 05975 COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER 0.0600 0.0000 0.0600 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 08648 ESPARADRAPO 10 X 4.5 CM CM 0.4000 0.0000 0.4000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 05444 CLORETO DE POTASSIO 15% 10 ML SI IV AP 1.3700 1.0300 0.3400 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 00817 ALGODAO HIDROFILO BOLINHA UN 0.5100 0.2600 0.2500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 02720 BOLSA COLETORA (SISTEMA ABERTO) UN 1.2800 0.9600 0.3200 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1765 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 29020166 Nebulização Simples com Broncodilatador 0.0000 1.1700 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 26981 SORO FISIOLOGICO 0,9% 10 ML SI IV AP 0.0000 0.1400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 26981 SORO FISIOLOGICO 0,9% 10 ML SI IV AP 0.0000 0.1400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 25040014 Fisioterapia Respiratória - em Doente Clínico Internado 0.0000 50.2800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 20691 HIDROCORTISONA 100 MG PO IM IV FA 0.0000 2.8300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 20691 HIDROCORTISONA 100 MG PO IM IV FA 0.0000 2.8300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 20691 HIDROCORTISONA 100 MG PO IM IV FA 0.0000 2.8300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 01691 NISTATINA 100.000 UI/ML SU VO ML 0.0000 0.2950 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 01691 NISTATINA 100.000 UI/ML SU VO ML 0.0000 0.2950 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 00128 LUVA DE PROCEDIMENTO UNIDADE UN 0.0000 0.1665 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 00128 LUVA DE PROCEDIMENTO UNIDADE UN 0.0000 1.6700 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 00380 SALBUTAMOL 100 MCG SY VO DS NULL 0.0000 NULL OPME INVALIDO 2201
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1765 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1765 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1765 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1765 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1765 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1765 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1765 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1765 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1765 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1765 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 51241 AGULHA 123X45 0.0000 0.1900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 51241 AGULHA 123X45 0.0000 0.1900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 51588 ESPARADRAPO MICROPORE 50 X 10 CM CM 0.0000 0.5400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 51659 FENOTEROL 2 MG/ML 10 ML AE IN DS 0.0000 0.2567 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 00090 SERINGA DESC 20 ML UN 0.0000 0.5375 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 00090 SERINGA DESC 20 ML UN 0.0000 0.5373 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 00090 SERINGA DESC 20 ML UN 0.0000 0.5373 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 00090 SERINGA DESC 20 ML UN 0.0000 0.5373 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 00090 SERINGA DESC 20 ML UN 0.0000 0.5373 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 00090 SERINGA DESC 20 ML UN 0.0000 0.5373 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 00090 SERINGA DESC 20 ML UN 0.0000 0.5373 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 61e4786d45edfdbf19b77fb2c6ce6b9c REINALDO 12754482747 NULL 12754482747 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 61e4786d45edfdbf19b77fb2c6ce6b9c REINALDO 12754482747 NULL 12754482747 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 61e4786d45edfdbf19b77fb2c6ce6b9c REINALDO 12754482747 NULL 12754482747 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 61e4786d45edfdbf19b77fb2c6ce6b9c REINALDO 12754482747 NULL 12754482747 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 61e4786d45edfdbf19b77fb2c6ce6b9c REINALDO 12754482747 NULL 12754482747 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 61e4786d45edfdbf19b77fb2c6ce6b9c REINALDO 12754482747 NULL 12754482747 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 61e4786d45edfdbf19b77fb2c6ce6b9c REINALDO 12754482747 NULL 12754482747 51589 ESPARADRAPO 10 X 4.5 CM CM 0.0000 0.4000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 61e4786d45edfdbf19b77fb2c6ce6b9c REINALDO 12754482747 NULL 12754482747 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 61e4786d45edfdbf19b77fb2c6ce6b9c REINALDO 12754482747 NULL 12754482747 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 61e4786d45edfdbf19b77fb2c6ce6b9c REINALDO 12754482747 NULL 12754482747 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 61e4786d45edfdbf19b77fb2c6ce6b9c REINALDO 12754482747 NULL 12754482747 00881 DEXCLORFENIRAMINA 2 MG CP VO UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4072 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4072 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 00090 SERINGA DESC 20 ML UN 0.0000 0.5343 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 081fdadb830fb547e83c43fabdb88372 ELZA 12377335349 NULL 12377335349 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 081fdadb830fb547e83c43fabdb88372 ELZA 12377335349 NULL 12377335349 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 081fdadb830fb547e83c43fabdb88372 ELZA 12377335349 NULL 12377335349 01611 CLORETO DE POTASSIO 600 MG CA VO UN 0.0000 0.4900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 081fdadb830fb547e83c43fabdb88372 ELZA 12377335349 NULL 12377335349 01611 CLORETO DE POTASSIO 600 MG CA VO UN 0.0000 0.4900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 081fdadb830fb547e83c43fabdb88372 ELZA 12377335349 NULL 12377335349 01611 CLORETO DE POTASSIO 600 MG CA VO UN 0.0000 0.4900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 081fdadb830fb547e83c43fabdb88372 ELZA 12377335349 NULL 12377335349 01611 CLORETO DE POTASSIO 600 MG CA VO UN 0.0000 0.4900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 081fdadb830fb547e83c43fabdb88372 ELZA 12377335349 NULL 12377335349 25040014 Fisioterapia Respiratória - em Doente Clínico Internado 0.0000 0.3500 NULL EXAME SEM REGISTRO DE EXECUCAO 2703
Glosa Min 2018-10-03 00:00:00.000000 1084117 081fdadb830fb547e83c43fabdb88372 ELZA 12377335349 NULL 12377335349 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 081fdadb830fb547e83c43fabdb88372 ELZA 12377335349 NULL 12377335349 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1800 NULL PAGO CONFORME RELATORIO DE AUDITORIA EXTERNA ― CONTA INICIAL 1717
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6860 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 51379 SERINGA DESC 05 ML UN 0.0000 0.1900 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 51379 SERINGA DESC 05 ML UN 0.0000 0.1900 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 51379 SERINGA DESC 05 ML UN 0.0000 0.1900 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 51379 SERINGA DESC 05 ML UN 0.0000 0.1900 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 51379 SERINGA DESC 05 ML UN 0.0000 0.1900 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 51379 SERINGA DESC 05 ML UN 0.0000 0.1900 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 51379 SERINGA DESC 05 ML UN 0.0000 0.1900 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 51588 ESPARADRAPO MICROPORE 50 X 10 CM CM 0.0000 0.7700 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 345c226bfea274af1372d41b0305a6c8 ALTINO 12720257940 NULL 12720257940 25722 OMEPRAZOL 40 MG + DIL. 10 ML PO IV FA 0.0000 0.0000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 345c226bfea274af1372d41b0305a6c8 ALTINO 12720257940 NULL 12720257940 25722 OMEPRAZOL 40 MG + DIL. 10 ML PO IV FA 0.0000 6.9300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 345c226bfea274af1372d41b0305a6c8 ALTINO 12720257940 NULL 12720257940 00172 SORO FISIOLOGICO 0,9% 500 ML SI IV BS 0.0000 0.0000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 345c226bfea274af1372d41b0305a6c8 ALTINO 12720257940 NULL 12720257940 00493 BROMOPRIDA 5 MG/ML 2 ML SI IM IV AP 0.0000 2.7300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 345c226bfea274af1372d41b0305a6c8 ALTINO 12720257940 NULL 12720257940 00493 BROMOPRIDA 5 MG/ML 2 ML SI IM IV AP 0.0000 2.7300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 00127 LUVA DE PROCEDIMENTO UNIDADE UN 0.0000 0.6700 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 00128 LUVA DE PROCEDIMENTO UNIDADE UN 0.0000 1.0000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 00128 LUVA DE PROCEDIMENTO UNIDADE UN 0.0000 1.0000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 00128 LUVA DE PROCEDIMENTO UNIDADE UN 0.0000 1.0000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 00090 SERINGA DESC 20 ML UN 0.0000 0.5400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 00090 SERINGA DESC 20 ML UN 0.0000 0.5400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 00919 ALGODAO HIDROFILO BOLINHA UN 0.0000 0.2600 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 01652 TRAMADOL 50 MG CP VO UN 0.0000 1.9300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6875 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6875 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.8100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 51589 ESPARADRAPO 10 X 4.5 CM CM 0.0000 0.4000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3fb5c891f31bb9efcb05395066127c52 ALAIDE 12636273441 NULL 12636273441 00487 RANITIDINA 25 MG/ML 2 ML SI IM IV AP 0.0000 0.0000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 610c198ec4c064687cf0524f147d3aed ROBERTO 12748814743 NULL 12748814743 16322 BENZILPENICILINA POTASSICA CRIST. 5.000.000 8.0700 8.0685 0.0017 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 610c198ec4c064687cf0524f147d3aed ROBERTO 12748814743 NULL 12748814743 16322 BENZILPENICILINA POTASSICA CRIST. 5.000.000 8.0700 8.0683 0.0017 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 51378 SERINGA DESC 03 ML UN 0.1500 0.0600 0.0900 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 51378 SERINGA DESC 03 ML UN 0.1500 0.0600 0.0900 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00127 LUVA DE PROCEDIMENTO UNIDADE UN 0.3300 0.1300 0.2000 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00127 LUVA DE PROCEDIMENTO UNIDADE UN 0.3300 0.1300 0.2000 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00127 LUVA DE PROCEDIMENTO UNIDADE UN 0.3300 0.1300 0.2000 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.4000 0.1600 0.2400 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.4000 0.1600 0.2400 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.4000 0.1600 0.2400 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.4000 0.1600 0.2400 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.4000 0.1600 0.2400 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.4000 0.1600 0.2400 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.4000 0.1600 0.2400 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.4000 0.1600 0.2400 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00020010 Visita Hospitalar (Paciente Internado) 43.8000 17.1000 26.7000 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 07802 PIPERACILINA 4 G + TAZOBACTAM 500 MG PO IV FA 83.4500 32.5900 50.8600 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 54175 DIETA SEMI ELEMENTAR 1.0 KCAL/ML EM EN ML 86.4000 33.7400 52.6600 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 54178 DIETA SEMI ELEMENTAR C/ IMUNOMODDULADORES 1.5 KCA 115.2000 44.9800 70.2200 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 01081197 5125859e8d2860b83822c41756a9b5bf ESMERALDA 12734516820 NULL 12734516820... 32010028 RX Crânio: P.A. - Lat.- Bretton 0.0000 0.0060 NULL EXAME SEM REGISTRO DE EXECUCAO 2703
Glosa Min 2018-10-03 00:00:00.000000 01081197 e0b1f77dc9cff210f2fbead99c7ba4d4 MARCIO 12790052920 NULL 12790052920 00097 ABOCATH N 14 A 22 UN NULL 0.0000 NULL OPME INVALIDO 2201
Glosa Min 2018-10-03 00:00:00.000000 01081197 3af14fcc4f764a77ed38b3d2e81bcc76 JOAO 12687535922 NULL 12687535922 53895 OMNIPAQUE (IOEXOL) 300 MG/IML SI IT IV VO ML NULL 0.0000 NULL OPME INVALIDO 2201
Glosa Min 2018-10-03 00:00:00.000000 01081197 3af14fcc4f764a77ed38b3d2e81bcc76 JOAO 12687535922 NULL 12687535922 00097 ABOCATH N 14 A 22 UN NULL 0.0000 NULL OPME INVALIDO 2201
Glosa Min 2018-10-03 00:00:00.000000 1084117 16b1e9f62f247f02ad5cac910ee15b4e BERCHOLINA 12631612848 NULL 12631612848 00171 SORO FISIOLOGICO 0,9% 250 ML SI IV BS 3.9400 3.7600 0.1800 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 16b1e9f62f247f02ad5cac910ee15b4e BERCHOLINA 12631612848 NULL 12631612848 04073 TRAMADOL 50 MG 1 ML SI IM IV AP 4.1900 4.0000 0.1900 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 16b1e9f62f247f02ad5cac910ee15b4e BERCHOLINA 12631612848 NULL 12631612848 04073 TRAMADOL 50 MG 1 ML SI IM IV AP 4.1900 4.0000 0.1900 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 16b1e9f62f247f02ad5cac910ee15b4e BERCHOLINA 12631612848 NULL 12631612848 22421 PIPERACILINA 2 G + TAZOBACTAM 250 MG 30 ML PO IV 55.3400 52.7400 2.6000 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 16b1e9f62f247f02ad5cac910ee15b4e BERCHOLINA 12631612848 NULL 12631612848 22421 PIPERACILINA 2 G + TAZOBACTAM 250 MG 30 ML PO IV 55.3400 52.7400 2.6000 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 16b1e9f62f247f02ad5cac910ee15b4e BERCHOLINA 12631612848 NULL 12631612848 22421 PIPERACILINA 2 G + TAZOBACTAM 250 MG 30 ML PO IV 55.3400 52.7400 2.6000 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 16b1e9f62f247f02ad5cac910ee15b4e BERCHOLINA 12631612848 NULL 12631612848 22421 PIPERACILINA 2 G + TAZOBACTAM 250 MG 30 ML PO IV 55.3400 52.7400 2.6000 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.0000 0.1800 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 02720 BOLSA COLETORA (SISTEMA ABERTO) UN 1.2800 0.6400 0.6400 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 32204 CLORETO DE SODIO 0,9% 10 ML SI IV AP 0.9600 0.0000 0.9600 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 32204 CLORETO DE SODIO 0,9% 10 ML SI IV AP 0.9600 0.0000 0.9600 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 00485 AGUA BIDESTILADA 500 ML SI IM IV BS 6.4300 0.0000 6.4300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 28959 DERSANI LC TP ML 19.4000 14.5500 4.8500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 37761 ALCOOL ETILICO 70 % ST TP ML 0.0600 0.0300 0.0300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 28959 DERSANI LC TP ML 19.4000 14.5500 4.8500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 00485 AGUA BIDESTILADA 500 ML SI IM IV BS 6.4300 0.0000 6.4300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 02720 BOLSA COLETORA (SISTEMA ABERTO) UN 1.2800 0.6400 0.6400 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 d17b3c5ae418d82694895a326dee545a ODILIA 12670516743 NULL 12670516743 00817 ALGODAO HIDROFILO BOLINHA UN 0.2600 0.1300 0.1300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 d17b3c5ae418d82694895a326dee545a ODILIA 12670516743 NULL 12670516743 00817 ALGODAO HIDROFILO BOLINHA UN 0.2600 0.1300 0.1300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 d17b3c5ae418d82694895a326dee545a ODILIA 12670516743 NULL 12670516743 37761 ALCOOL ETILICO 70 % ST TP ML 0.0300 0.0200 0.0100 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 d17b3c5ae418d82694895a326dee545a ODILIA 12670516743 NULL 12670516743 32204 CLORETO DE SODIO 0,9% 10 ML SI IV AP 0.9600 0.0000 0.9600 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 d17b3c5ae418d82694895a326dee545a ODILIA 12670516743 NULL 12670516743 37761 ALCOOL ETILICO 70 % ST TP ML 0.0300 0.0200 0.0100 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 37761 ALCOOL ETILICO 70 % ST TP ML 0.0300 0.0200 0.0100 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 33219 LUVA DE PROCEDIMENTO UNIDADE UN 1.0000 0.6700 0.3300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 33219 LUVA DE PROCEDIMENTO UNIDADE UN 1.6700 0.6700 1.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 de1a8276d878171456d7fc8f6dcd2457 ABEL 12764206443 NULL 12764206443 58750 AGULHA P/ PUNÇAO PERCUTANEA UN 82.0000 0.0000 82.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 11193 CLOREXIDINA 2 % ST TP ML 0.4000 0.2700 0.1300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 20567 SORO FISIOLOGICO 0,9% 500 ML SI IV BS 4.7300 0.0000 4.7300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 32204 CLORETO DE SODIO 0,9% 10 ML SI IV AP 0.9600 0.0000 0.9600 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 37761 ALCOOL ETILICO 70 % ST TP ML 0.0300 0.0200 0.0100 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 53660 EQUIPO MACRO-GOTAS FLEXIVEL C/ INJETOR LATE 4.7700 0.0000 4.7700 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 34789 SONDA ASPIRAÇAO C/ VALVULA - TODAS - UTI UN 2.8100 1.8700 0.9400 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00817 ALGODAO HIDROFILO BOLINHA UN 0.5100 0.2600 0.2500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00817 ALGODAO HIDROFILO BOLINHA UN 0.5100 0.2600 0.2500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00817 ALGODAO HIDROFILO BOLINHA UN 0.5100 0.2600 0.2500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00817 ALGODAO HIDROFILO BOLINHA UN 0.5100 0.2600 0.2500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00817 ALGODAO HIDROFILO BOLINHA UN 0.5100 0.2600 0.2500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00817 ALGODAO HIDROFILO BOLINHA UN 0.5100 0.2600 0.2500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 752c651cb4fd049e19c685f87fbe8bdc EDUARDO 12765990646 NULL 12765990646 32891 EQUIPO POLIFIX 2ş VIAS UN 2.5500 0.0000 2.5500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 752c651cb4fd049e19c685f87fbe8bdc EDUARDO 12765990646 NULL 12765990646 00817 ALGODAO HIDROFILO BOLINHA UN 0.5100 0.1300 0.3800 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 752c651cb4fd049e19c685f87fbe8bdc EDUARDO 12765990646 NULL 12765990646 37761 ALCOOL ETILICO 70 % ST TP ML 0.0600 0.0200 0.0400 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 752c651cb4fd049e19c685f87fbe8bdc EDUARDO 12765990646 NULL 12765990646 00817 ALGODAO HIDROFILO BOLINHA UN 0.5100 0.1300 0.3800 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3d5131ef222e15b77c298e3372afc496 MARIA 12665213047 NULL 12665213047 29700 HENETIX (IOBITRIDOL) 300 MG/ML SI IV ML 359.5000 179.7500 179.7500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 33219 LUVA DE PROCEDIMENTO UNIDADE UN 1.0000 0.6700 0.3300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 37761 ALCOOL ETILICO 70 % ST TP ML 0.0300 0.0200 0.0100 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 345c226bfea274af1372d41b0305a6c8 ALTINO 12720257940 NULL 12720257940 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1000 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 345c226bfea274af1372d41b0305a6c8 ALTINO 12720257940 NULL 12720257940 21822 TRAMADOL 50 MG 1 ML SI IM IV AP 4.1900 4.1900 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 345c226bfea274af1372d41b0305a6c8 ALTINO 12720257940 NULL 12720257940 07269 DIPIRONA 500 MG/ML 2 ML SI IV IM AP 0.6900 0.6860 0.0040 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 31d18d6607d9e742c53e748d6a55d740 CARLOS 12557779343 NULL 12557779343 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1760 0.0040 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 31d18d6607d9e742c53e748d6a55d740 CARLOS 12557779343 NULL 12557779343 07269 DIPIRONA 500 MG/ML 2 ML SI IV IM AP 0.6900 0.6860 0.0040 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 31d18d6607d9e742c53e748d6a55d740 CARLOS 12557779343 NULL 12557779343 07269 DIPIRONA 500 MG/ML 2 ML SI IV IM AP 0.6900 0.6860 0.0040 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 0405a686318e3fc262f105ed4be24d95 CARMELITA 12687161644 NULL 12687161644 07269 DIPIRONA 500 MG/ML 2 ML SI IV IM AP 0.6900 0.6873 0.0027 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 0405a686318e3fc262f105ed4be24d95 CARMELITA 12687161644 NULL 12687161644 07269 DIPIRONA 500 MG/ML 2 ML SI IV IM AP 0.6900 0.6873 0.0027 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 0405a686318e3fc262f105ed4be24d95 CARMELITA 12687161644 NULL 12687161644 07269 DIPIRONA 500 MG/ML 2 ML SI IV IM AP 0.6900 0.6873 0.0027 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 ea6abb4182a48f0934f3e9eb5affa056 DILVA 12697455440 NULL 12697455440 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1750 0.0050 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 ea6abb4182a48f0934f3e9eb5affa056 DILVA 12697455440 NULL 12697455440 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1750 0.0050 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 752c651cb4fd049e19c685f87fbe8bdc EDUARDO 12765990646 NULL 12765990646 00817 ALGODAO HIDROFILO BOLINHA UN 0.5100 0.1300 0.3800 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 27600 ONDANSETRONA 2 MG/ML 4 ML SI IM IV AP 13.5300 0.0000 13.5300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 27600 ONDANSETRONA 2 MG/ML 4 ML SI IM IV AP 13.5300 0.0000 13.5300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 27600 ONDANSETRONA 2 MG/ML 4 ML SI IM IV AP 13.5300 0.0000 13.5300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 33219 LUVA DE PROCEDIMENTO UNIDADE UN 0.3300 0.0000 0.3300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 19135 SERINGA DESC 03 ML UN 0.1500 0.0000 0.1500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 08664 ESPARADRAPO MICROPORE 50 X 10 CM CM 0.2600 0.2561 0.0039 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd6f8d6c53ffe9bfd3aa9590ba500cc8 ILDA 12751932542 NULL 12751932542 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 1.3600 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 00090 SERINGA DESC 20 ML UN 0.0000 0.5375 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 00090 SERINGA DESC 20 ML UN 0.0000 0.5375 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 00090 SERINGA DESC 20 ML UN 0.0000 0.5375 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 51671 REPARIL (ESCINA + DIETILAMONIO) GL TP GR 0.0000 0.0000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 51671 REPARIL (ESCINA + DIETILAMONIO) GL TP GR 0.0000 0.0000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 51671 REPARIL (ESCINA + DIETILAMONIO) GL TP GR 0.0000 0.0000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 51671 REPARIL (ESCINA + DIETILAMONIO) GL TP GR 0.0000 3.7500 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1775 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1775 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1775 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1775 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.8074 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.8074 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.8074 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.8067 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.8067 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.8074 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.8074 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.8074 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00090 SERINGA DESC 20 ML UN 0.0000 0.5375 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00090 SERINGA DESC 20 ML UN 0.0000 0.5375 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00090 SERINGA DESC 20 ML UN 0.0000 0.5375 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00090 SERINGA DESC 20 ML UN 0.0000 0.5375 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00090 SERINGA DESC 20 ML UN 0.0000 0.5375 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 54157 EQUIPO P/ DIETA ENTERAL UN 0.0000 1.7000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 51649 ALCOOL ETILICO 70 % ST TP ML 0.0000 0.0300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 51649 ALCOOL ETILICO 70 % ST TP ML 0.0000 0.0300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1776 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1776 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1776 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.4000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.4000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.4000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00487 RANITIDINA 25 MG/ML 2 ML SI IM IV AP 0.0000 0.9300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00037 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 35382 COMPRESSAS DE GASES 7.5 X7,5 (11 FIOS ESTERIL) UN 0.0000 0.6000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6871 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6871 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6871 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 11325 EQUIPO MACRO-GOTAS FLEXIVEL C/ INJETOR LATERAL UN 0.0000 1.5900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 11325 EQUIPO MACRO-GOTAS FLEXIVEL C/ INJETOR LATERAL UN 0.0000 1.5900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 11325 EQUIPO MACRO-GOTAS FLEXIVEL C/ INJETOR LATERAL UN 0.0000 1.5900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 2e6b6f291f2df9beb1fbda6028678909 ANNA 12463693448 NULL 12463693448 09070 ACETILCISTEINA 600MG PO VO SA 0.0000 3.5000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 2e6b6f291f2df9beb1fbda6028678909 ANNA 12463693448 NULL 12463693448 09070 ACETILCISTEINA 600MG PO VO SA 0.0000 3.5000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 2e6b6f291f2df9beb1fbda6028678909 ANNA 12463693448 NULL 12463693448 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 2e6b6f291f2df9beb1fbda6028678909 ANNA 12463693448 NULL 12463693448 29020166 Nebulização Simples com Broncodilatador 0.0000 4.6800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 2e6b6f291f2df9beb1fbda6028678909 ANNA 12463693448 NULL 12463693448 29020166 Nebulização Simples com Broncodilatador 0.0000 4.8400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 2e6b6f291f2df9beb1fbda6028678909 ANNA 12463693448 NULL 12463693448 00184 CLORETO DE POTASSIO 10% 10 ML SI IV AP 0.0000 0.3000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 2e6b6f291f2df9beb1fbda6028678909 ANNA 12463693448 NULL 12463693448 00184 CLORETO DE POTASSIO 10% 10 ML SI IV AP 0.0000 0.3000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00091 SERINGA DESC 01 ML (INSULINA) UN 0.0000 0.0000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00090 SERINGA DESC 20 ML UN 0.0000 0.5367 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00090 SERINGA DESC 20 ML UN 0.0000 0.5367 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00090 SERINGA DESC 20 ML UN 0.0000 0.5367 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00090 SERINGA DESC 20 ML UN 0.0000 0.5367 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00090 SERINGA DESC 20 ML UN 0.0000 0.5367 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00069 SERINGA DESC 10 ML UN 0.0000 0.6657 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 25030019 Distúrbios Circulatórios Artério - Venosos e Linfáticos 0.0000 45.8500 NULL COBRANCA DE PROCEDIMENTO/EXAME SEM JUSTIFICATIVA PARA REALIZACAO OU COM JUSTIFICATIVA INSUFICIENTE 2705
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 02355 AMOXICILINA 1 G + CLAVULANATO 200 MG + DIL. 10 ML 0.0000 36.4667 NULL COBRANCA DE MEDICAMENTO EM QUANTIDADE INCOMPATIVEL COM A PERMANENCIA 2107
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 02355 AMOXICILINA 1 G + CLAVULANATO 200 MG + DIL. 10 ML 0.0000 36.4667 NULL COBRANCA DE MEDICAMENTO EM QUANTIDADE INCOMPATIVEL COM A PERMANENCIA 2107
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 02355 AMOXICILINA 1 G + CLAVULANATO 200 MG + DIL. 10 ML 0.0000 36.4667 NULL COBRANCA DE MEDICAMENTO EM QUANTIDADE INCOMPATIVEL COM A PERMANENCIA 2107
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 01611 CLORETO DE POTASSIO 600 MG CA VO UN 0.0000 0.4870 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4072 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4072 NULL COBRANCA DE MEDICAMENTO EM QUANTIDADE INCOMPATIVEL COM A PERMANENCIA 2107
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4072 NULL COBRANCA DE MEDICAMENTO EM QUANTIDADE INCOMPATIVEL COM A PERMANENCIA 2107
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4072 NULL COBRANCA DE MEDICAMENTO EM QUANTIDADE INCOMPATIVEL COM A PERMANENCIA 2107
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4072 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4072 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4072 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4072 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4072 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4072 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4072 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4072 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00124 LUVA CIRURGICA UN 0.0000 1.4475 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00124 LUVA CIRURGICA UN 0.0000 1.4475 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 15f461c0ca379f375bd9f8b18fbb101a ANA 12753753845 NULL 12753753845 55279 TRAMADOL 50 MG 1 ML SI IM IV AP 0.0000 4.1900 NULL COBRANCA DE MEDICAMENTO INCOMPATIVEL COM O RELATORIO TECNICO 2112
Glosa Min 2018-10-03 00:00:00.000000 1084117 15f461c0ca379f375bd9f8b18fbb101a ANA 12753753845 NULL 12753753845 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR APRESENTADO A MAIOR 1705
Glosa Min 2018-10-03 00:00:00.000000 1084117 15f461c0ca379f375bd9f8b18fbb101a ANA 12753753845 NULL 12753753845 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR APRESENTADO A MAIOR 1705
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 00919 ALGODAO HIDROFILO BOLINHA UN 0.0000 0.5100 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 09070 ACETILCISTEINA 600MG PO VO SA 0.0000 3.5000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 09070 ACETILCISTEINA 600MG PO VO SA 0.0000 3.5000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 54653 DERSANI LC TP ML 0.0000 9.7048 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 52392 SONDA DE ASPIRAÇAO TRAQUEAL C/ VALVULA UN 0.0000 0.9352 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 52392 SONDA DE ASPIRAÇAO TRAQUEAL C/ VALVULA UN 0.0000 0.9352 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 26981 SORO FISIOLOGICO 0,9% 10 ML SI IV AP 0.0000 0.9600 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 26981 SORO FISIOLOGICO 0,9% 10 ML SI IV AP 0.0000 0.9600 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 26981 SORO FISIOLOGICO 0,9% 10 ML SI IV AP 0.0000 0.9600 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 26981 SORO FISIOLOGICO 0,9% 10 ML SI IV AP 0.0000 0.9600 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 26981 SORO FISIOLOGICO 0,9% 10 ML SI IV AP 0.0000 0.9600 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 26981 SORO FISIOLOGICO 0,9% 10 ML SI IV AP 0.0000 0.9600 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 26981 SORO FISIOLOGICO 0,9% 10 ML SI IV AP 0.0000 0.9600 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 26981 SORO FISIOLOGICO 0,9% 10 ML SI IV AP 0.0000 0.9600 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 26981 SORO FISIOLOGICO 0,9% 10 ML SI IV AP 0.0000 0.4800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 26981 SORO FISIOLOGICO 0,9% 10 ML SI IV AP 0.0000 0.4800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 26981 SORO FISIOLOGICO 0,9% 10 ML SI IV AP 0.0000 0.4800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 26981 SORO FISIOLOGICO 0,9% 10 ML SI IV AP 0.0000 0.4800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 02246 HIDROCORTISONA 100 MG PO IM IV FA 0.0000 2.8300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 02246 HIDROCORTISONA 100 MG PO IM IV FA 0.0000 2.8300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 02246 HIDROCORTISONA 100 MG PO IM IV FA 0.0000 2.8300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 01496 FENITOINA 50 MG/ML 5 ML SI IM IV AP 0.0000 2.3400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 01496 FENITOINA 50 MG/ML 5 ML SI IM IV AP 0.0000 2.3400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 01496 FENITOINA 50 MG/ML 5 ML SI IM IV AP 0.0000 2.3400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 01496 FENITOINA 50 MG/ML 5 ML SI IM IV AP 0.0000 2.3400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 01496 FENITOINA 50 MG/ML 5 ML SI IM IV AP 0.0000 2.3400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 01496 FENITOINA 50 MG/ML 5 ML SI IM IV AP 0.0000 2.3400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 01496 FENITOINA 50 MG/ML 5 ML SI IM IV AP 0.0000 2.3400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4094 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4094 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4094 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 00090 SERINGA DESC 20 ML UN 0.0000 0.5376 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 00090 SERINGA DESC 20 ML UN 0.0000 0.5376 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1773 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1773 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1773 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1773 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1773 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1773 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.8078 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 02246 HIDROCORTISONA 100 MG PO IM IV FA 0.0000 2.8300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 01611 CLORETO DE POTASSIO 600 MG CA VO UN 0.0000 0.4867 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 01611 CLORETO DE POTASSIO 600 MG CA VO UN 0.0000 0.4867 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 00090 SERINGA DESC 20 ML UN 0.0000 0.5379 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 00090 SERINGA DESC 20 ML UN 0.0000 0.5379 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 00090 SERINGA DESC 20 ML UN 0.0000 0.5379 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 4c68006246c347121db1f06edf5e5051 MARIA 12734155245 NULL 12734155245 00172 SORO FISIOLOGICO 0,9% 500 ML SI IV BS 0.0000 4.7300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cd2840524be5a3f1d0939f241e24f32b MARIA 12705908340 NULL 12705908340 00090 SERINGA DESC 20 ML UN 0.0000 0.5367 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cd2840524be5a3f1d0939f241e24f32b MARIA 12705908340 NULL 12705908340 55060153 Toracotomia com Drenagem Fechada 0.0000 1.7100 NULL COBRANCA DE HONORARIOS EM DUPLICIDADE 2607
Glosa Min 2018-10-03 00:00:00.000000 1084117 cd2840524be5a3f1d0939f241e24f32b MARIA 12705908340 NULL 12705908340 00487 RANITIDINA 25 MG/ML 2 ML SI IM IV AP 0.0000 0.9300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cd2840524be5a3f1d0939f241e24f32b MARIA 12705908340 NULL 12705908340 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cd2840524be5a3f1d0939f241e24f32b MARIA 12705908340 NULL 12705908340 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cd2840524be5a3f1d0939f241e24f32b MARIA 12705908340 NULL 12705908340 00184 CLORETO DE POTASSIO 10% 10 ML SI IV AP 0.0000 0.2967 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cd2840524be5a3f1d0939f241e24f32b MARIA 12705908340 NULL 12705908340 00184 CLORETO DE POTASSIO 10% 10 ML SI IV AP 0.0000 0.2967 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cd2840524be5a3f1d0939f241e24f32b MARIA 12705908340 NULL 12705908340 00181 SULFATO DE MAGNESIO 100 MG/ML 10 ML SI IM IV 0.0000 0.9467 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cd2840524be5a3f1d0939f241e24f32b MARIA 12705908340 NULL 12705908340 00181 SULFATO DE MAGNESIO 100 MG/ML 10 ML SI IM IV 0.0000 0.9464 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 52303 NOREPINEFRINA 2 MG/ML 4 ML SI IV AP 0.0000 66.4700 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 52303 NOREPINEFRINA 2 MG/ML 4 ML SI IV AP 0.0000 56.9800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 52303 NOREPINEFRINA 2 MG/ML 4 ML SI IV AP 0.0000 56.9800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 51584 ESPARADRAPO MICROPORE 0.0000 0.2560 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 51584 ESPARADRAPO MICROPORE 0.0000 0.2560 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 51584 ESPARADRAPO MICROPORE 0.0000 0.2560 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 51584 ESPARADRAPO MICROPORE 0.0000 0.2560 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 51508 ENCRISE (ARGIPRESSINA) 20 U/ML 1 ML SI IM IV SC AP 0.0000 20.1200 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.4000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 00487 RANITIDINA 25 MG/ML 2 ML SI IM IV AP 0.0000 0.9300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 22421 PIPERACILINA 2 G + TAZOBACTAM 250 MG 30 ML PO IV 0.0000 55.3400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 00170 SORO GLICOSADO 5% 250 ML SI IV BS 0.0000 6.7900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4070 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4070 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4070 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4070 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1766 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1766 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 36010014 Rm de Crânio 0.0000 0.0000 NULL EXAME SEM REGISTRO DE EXECUCAO 2703
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6872 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6872 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6872 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6872 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6872 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6872 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4088 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4088 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4088 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4088 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4088 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4088 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4088 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00796 FLORATIL (SACCHAROMYCES BOULARDII) 200 MG PO VO 0.0000 4.4400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 55030165 Desobstrução Traqueal a Laser 0.0000 0.0000 NULL COBRANCA DE HONORARIOS EM DUPLICIDADE 2607
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 54995 EQUIPO P/ BOMBA DE INFUSAO ENTERAL / PARENTERAL U UN 0.0000 1.7485 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 54756 HIDANTAL 0.0000 0.1860 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 51584 ESPARADRAPO MICROPORE 0.0000 0.2560 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 51584 ESPARADRAPO MICROPORE 0.0000 0.2560 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 51584 ESPARADRAPO MICROPORE 0.0000 0.2600 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 51578 Frasco p/ alimentacao enteral 0.0000 2.4700 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 51419 FILTRO DE BARREIRA 0.0000 2.9900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 51379 SERINGA DESC 05 ML UN 0.0000 0.1900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00487 RANITIDINA 25 MG/ML 2 ML SI IM IV AP 0.0000 2.8000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00487 RANITIDINA 25 MG/ML 2 ML SI IM IV AP 0.0000 0.9300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6875 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6875 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6875 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 26981 SORO FISIOLOGICO 0,9% 10 ML SI IV AP 0.0000 0.9600 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 26981 SORO FISIOLOGICO 0,9% 10 ML SI IV AP 0.0000 0.9600 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 26981 SORO FISIOLOGICO 0,9% 10 ML SI IV AP 0.0000 0.9600 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 24082 BROMOPRIDA 5 MG/ML 2 ML SI IM IV AP 0.0000 2.7300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00124 LUVA CIRURGICA UN 0.0000 1.4475 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 75bcd473a0dc7c7a6751499b38a4a034 JOAQUIM 12692852143 NULL 12692852143 51710 CLORETO DE POTASSIO 15% 10 ML SI IV AP 0.0000 0.6850 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 75bcd473a0dc7c7a6751499b38a4a034 JOAQUIM 12692852143 NULL 12692852143 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6850 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 75bcd473a0dc7c7a6751499b38a4a034 JOAQUIM 12692852143 NULL 12692852143 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6850 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 75bcd473a0dc7c7a6751499b38a4a034 JOAQUIM 12692852143 NULL 12692852143 21010218 Painel de imuno - Histoquímica (Imunoperoxidase e Imunofluorescência) para Diagnóstico Diferencial de Neoplasias 0.0000 0.0000 NULL COBRANCA DE HONORARIOS EM DUPLICIDADE 2607
Glosa Min 2018-10-03 00:00:00.000000 1084117 75bcd473a0dc7c7a6751499b38a4a034 JOAQUIM 12692852143 NULL 12692852143 00172 SORO FISIOLOGICO 0,9% 500 ML SI IV BS 0.0000 4.7300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 75bcd473a0dc7c7a6751499b38a4a034 JOAQUIM 12692852143 NULL 12692852143 00172 SORO FISIOLOGICO 0,9% 500 ML SI IV BS 0.0000 4.7300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 75bcd473a0dc7c7a6751499b38a4a034 JOAQUIM 12692852143 NULL 12692852143 01652 TRAMADOL 50 MG CP VO UN 0.0000 1.9272 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 75bcd473a0dc7c7a6751499b38a4a034 JOAQUIM 12692852143 NULL 12692852143 01652 TRAMADOL 50 MG CP VO UN 0.0000 1.9272 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 75bcd473a0dc7c7a6751499b38a4a034 JOAQUIM 12692852143 NULL 12692852143 01652 TRAMADOL 50 MG CP VO UN 0.0000 1.9272 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 75bcd473a0dc7c7a6751499b38a4a034 JOAQUIM 12692852143 NULL 12692852143 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4075 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 75bcd473a0dc7c7a6751499b38a4a034 JOAQUIM 12692852143 NULL 12692852143 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4075 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 75bcd473a0dc7c7a6751499b38a4a034 JOAQUIM 12692852143 NULL 12692852143 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 4e13adf421809cb755e1bdd80cc4efed AGRIPINA 12385409142 NULL 12385409142 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 4e13adf421809cb755e1bdd80cc4efed AGRIPINA 12385409142 NULL 12385409142 51649 ALCOOL ETILICO 70 % ST TP ML 0.0000 0.0300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 4e13adf421809cb755e1bdd80cc4efed AGRIPINA 12385409142 NULL 12385409142 35382 COMPRESSAS DE GASES 7.5 X7,5 (11 FIOS ESTERIL) UN 0.0000 0.0300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 4e13adf421809cb755e1bdd80cc4efed AGRIPINA 12385409142 NULL 12385409142 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 35382 COMPRESSAS DE GASES 7.5 X7,5 (11 FIOS ESTERIL) UN 0.0000 0.0000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00613 CLINDAMICINA 600 MG 4 ML SI IM IV AP 0.0000 13.0800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 51708 Dieta Hipercalorica Hiperproteica Sem Fibras 1.5 kcal 0.0000 73.4000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 51622 MODULO DE PROTEINAS DO SORO DO LEITE PO EN GR 0.0000 6.6000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 51434 BECLOMETASONA 400 MCG / ML 2 ML SL IN FL 0.0000 4.4800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 51434 BECLOMETASONA 400 MCG / ML 2 ML SL IN FL 0.0000 4.4800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 51379 SERINGA DESC 05 ML UN 0.0000 0.1900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 51379 SERINGA DESC 05 ML UN 0.0000 0.1900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 51379 SERINGA DESC 05 ML UN 0.0000 0.1900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 51379 SERINGA DESC 05 ML UN 0.0000 0.1900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 51164 AGUA BIDESTILADA 500 ML 0.0000 6.4300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 51163 AGUA BIDESTILADA 250 ML 0.0000 5.7900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.4000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.4000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.0000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.4000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.4000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.4000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.0000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 1.3700 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 526685c1041cc1316e874a2e95e67e2e JOSE 12696604949 NULL 12696604949 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1760 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12558131243 NULL 12558131243 00919 ALGODAO HIDROFILO BOLINHA UN 0.0000 0.1000 NULL VALOR APRESENTADO A MAIOR 1705
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12558131243 NULL 12558131243 52010511 Fratura do Cóccix - Tratamento Cruento 0.0000 0.0000 NULL COBRANCA DE HONORARIOS EM DUPLICIDADE 2607
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12558131243 NULL 12558131243 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1757 NULL VALOR APRESENTADO A MAIOR 1705
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12558131243 NULL 12558131243 00501 DRAMIN B6 DL (DIMENIDRINATO + PIRIDOXINA + GLIC. 0.0000 2.2100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12558131243 NULL 12558131243 35382 COMPRESSAS DE GASES 7.5 X7,5 (11 FIOS ESTERIL) UN 0.0000 0.0000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12558131243 NULL 12558131243 25040014 Fisioterapia Respiratória - em Doente Clínico Internado 0.0000 12.2800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 752c651cb4fd049e19c685f87fbe8bdc EDUARDO 12765990646 NULL 12765990646 00069 SERINGA DESC 10 ML UN 0.0000 0.6650 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 752c651cb4fd049e19c685f87fbe8bdc EDUARDO 12765990646 NULL 12765990646 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6875 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 752c651cb4fd049e19c685f87fbe8bdc EDUARDO 12765990646 NULL 12765990646 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6875 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 800720d33fe0defb6121e82dd216d044 JALMO 12786952647 NULL 12786952647 00090 SERINGA DESC 20 ML UN 0.0000 0.5400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 800720d33fe0defb6121e82dd216d044 JALMO 12786952647 NULL 12786952647 00090 SERINGA DESC 20 ML UN 0.0000 0.5400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 800720d33fe0defb6121e82dd216d044 JALMO 12786952647 NULL 12786952647 00757 CEFUROXIMA 750 MG + DIL. 6 ML PO IM IV FA 0.0000 26.1300 NULL VALOR APRESENTADO A MAIOR 1705
Glosa Min 2018-10-03 00:00:00.000000 1084117 800720d33fe0defb6121e82dd216d044 JALMO 12786952647 NULL 12786952647 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 56261 CLOREXIDINA 2 % ST TP ML DEGERMANTE NULL 0.0000 NULL OPME INVALIDO 2201
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1d6bbb4a00130e2e654e830fc9bae6a ALEXANDRINA 12694224940 NULL 12694224940 05274 AMOXICILINA 500 MG + CLAVULANATO 125 MG CP 3.1700 3.1667 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1d6bbb4a00130e2e654e830fc9bae6a ALEXANDRINA 12694224940 NULL 12694224940 05274 AMOXICILINA 500 MG + CLAVULANATO 125 MG CP 3.1700 3.1667 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1d6bbb4a00130e2e654e830fc9bae6a ALEXANDRINA 12694224940 NULL 12694224940 05274 AMOXICILINA 500 MG + CLAVULANATO 125 MG CP 3.1700 3.1667 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 08664 ESPARADRAPO MICROPORE 50 X 10 CM CM 1.3564 1.3849 -0.8749 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 08664 ESPARADRAPO MICROPORE 50 X 10 CM CM 1.3564 1.3849 -0.8749 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 55018 ALGINATO DE CALCIO EM HIDROGEL GL TP GR 3.4500 3.4500 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 28959 DERSANI LC TP ML 12.6100 13.5800 -3.8800 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 05975 COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER 1.3439 1.3948 -0.7948 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 05975 COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER 1.3439 1.3948 -0.7948 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 27600 ONDANSETRONA 2 MG/ML 4 ML SI IM IV AP 81.1800 94.7100 -81.1800 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 09636 FLORATIL (SACCHAROMYCES BOULARDII) 200 MG P 4.4400 8.8851 -4.4451 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 09636 FLORATIL (SACCHAROMYCES BOULARDII) 200 MG P 4.4400 8.8851 -4.4451 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 09636 FLORATIL (SACCHAROMYCES BOULARDII) 200 MG P 4.4400 8.8851 -4.4451 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 33219 LUVA DE PROCEDIMENTO UNIDADE UN 0.3300 0.3350 -0.0050 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.4000 0.4037 -0.0037 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.4000 0.4037 -0.0037 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 19160 SERINGA DESC 20 ML UN 0.5400 0.5374 0.0026 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 19160 SERINGA DESC 20 ML UN 0.5400 0.5374 0.0026 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 19160 SERINGA DESC 20 ML UN 0.5400 0.5374 0.0026 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 19160 SERINGA DESC 20 ML UN 0.5400 0.5374 0.0026 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 19160 SERINGA DESC 20 ML UN 0.5400 0.5374 0.0026 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.2120 -0.1120 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.2120 -0.1120 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.2120 -0.1120 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.2120 -0.1120 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.2120 -0.1120 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 33227 LUVA CIRURGICA PAR UN 2.9000 2.9000 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 33227 LUVA CIRURGICA PAR UN 2.9000 2.9000 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 33227 LUVA CIRURGICA PAR UN 2.9000 2.9000 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 33227 LUVA CIRURGICA PAR UN 2.9000 2.9000 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 33227 LUVA CIRURGICA PAR UN 2.9000 4.3500 -1.4500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4072 0.0028 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4072 0.0028 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 6.8145 -3.4045 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 6.8145 -3.4045 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 6.8145 -3.4045 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 6.8145 -3.4045 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 6.8145 -3.4045 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 6.8145 -3.4045 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 33545 PIPERACILINA 4 G + TAZOBACTAM 500 MG PO IV 83.4500 83.4500 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 08664 ESPARADRAPO MICROPORE 50 X 10 CM CM 0.2600 0.0000 0.2600 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1770 0.0030 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1770 0.0030 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1770 0.0030 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12647284040 NULL 12647284040 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4086 0.0014 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12647284040 NULL 12647284040 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4086 0.0014 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12647284040 NULL 12647284040 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4086 0.0014 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12647284040 NULL 12647284040 20567 SORO FISIOLOGICO 0,9% 500 ML SI IV BS 9.4700 9.4697 0.0003 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12647284040 NULL 12647284040 08664 ESPARADRAPO MICROPORE 50 X 10 CM CM 0.7700 0.7667 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12647284040 NULL 12647284040 00035 ABOCATH (CATETER INTRAVENOSO) N. 14 A 22 UN 3.7700 3.7600 0.0000 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 610c198ec4c064687cf0524f147d3aed ROBERTO 12748814743 NULL 12748814743 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4083 0.0017 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 610c198ec4c064687cf0524f147d3aed ROBERTO 12748814743 NULL 12748814743 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4083 0.0017 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 610c198ec4c064687cf0524f147d3aed ROBERTO 12748814743 NULL 12748814743 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1767 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 610c198ec4c064687cf0524f147d3aed ROBERTO 12748814743 NULL 12748814743 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1767 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 610c198ec4c064687cf0524f147d3aed ROBERTO 12748814743 NULL 12748814743 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1767 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 75bcd473a0dc7c7a6751499b38a4a034 JOAQUIM 12692852143 NULL 12692852143 37761 ALCOOL ETILICO 70 % ST TP ML 0.0300 0.0000 0.0300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 75bcd473a0dc7c7a6751499b38a4a034 JOAQUIM 12692852143 NULL 12692852143 00817 ALGODAO HIDROFILO BOLINHA UN 0.1000 0.0000 0.1000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8079 0.0021 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 29661 NOREPINEFRINA 2 MG/ML 4 ML SI IV AP 75.9700 75.9700 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 29661 NOREPINEFRINA 2 MG/ML 4 ML SI IV AP 75.9700 75.9700 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 0111beed375944f60c7ad4a7fd4874f8 WALDIR 12746025744 NULL 12746025744 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8077 0.0023 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 0111beed375944f60c7ad4a7fd4874f8 WALDIR 12746025744 NULL 12746025744 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1773 0.0027 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 0111beed375944f60c7ad4a7fd4874f8 WALDIR 12746025744 NULL 12746025744 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1773 0.0027 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 0111beed375944f60c7ad4a7fd4874f8 WALDIR 12746025744 NULL 12746025744 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1773 0.0027 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 6799aa3de305405ab065aad5b599765c VANIR 12700232345 NULL 12700232345 07269 DIPIRONA 500 MG/ML 2 ML SI IV IM AP 0.6900 0.6870 0.0030 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 6799aa3de305405ab065aad5b599765c VANIR 12700232345 NULL 12700232345 07269 DIPIRONA 500 MG/ML 2 ML SI IV IM AP 0.6900 0.6870 0.0030 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 6799aa3de305405ab065aad5b599765c VANIR 12700232345 NULL 12700232345 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1750 0.0050 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 11193 CLOREXIDINA 2 % ST TP ML 0.5300 0.5300 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8092 0.0008 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8092 0.0008 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8092 0.0008 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8092 0.0008 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8092 0.0008 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 53660 EQUIPO MACRO-GOTAS FLEXIVEL C/ INJETOR LATE 1.5900 1.5900 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1776 0.0024 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1776 0.0024 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1776 0.0024 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1776 0.0024 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1776 0.0024 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1776 0.0024 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1776 0.0024 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 19160 SERINGA DESC 20 ML UN 0.5400 0.5384 0.0016 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 19160 SERINGA DESC 20 ML UN 0.5400 0.5384 0.0016 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 19160 SERINGA DESC 20 ML UN 0.5400 0.5384 0.0016 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 19160 SERINGA DESC 20 ML UN 0.5400 0.5384 0.0016 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 19160 SERINGA DESC 20 ML UN 0.5400 0.5384 0.0016 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 19151 SERINGA DESC 10 ML UN 0.3300 0.3333 -0.0033 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 19151 SERINGA DESC 10 ML UN 0.3300 0.3333 -0.0033 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 33227 LUVA CIRURGICA PAR UN 1.4500 1.4476 0.0024 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 33227 LUVA CIRURGICA PAR UN 1.4500 1.4476 0.0024 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 33227 LUVA CIRURGICA PAR UN 1.4500 1.4476 0.0024 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 33227 LUVA CIRURGICA PAR UN 1.4500 1.4476 0.0024 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 1.6200 0.0000 1.6200 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 1.2100 0.0000 1.2100 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1000 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1000 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1000 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1000 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1000 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1000 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1000 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1000 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1000 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 6ccea6ac8c216c032723aee73a9f81c9 PRISCILA 12662249242 NULL 12662249242 19160 SERINGA DESC 20 ML UN 0.5400 0.5373 0.0027 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 6ccea6ac8c216c032723aee73a9f81c9 PRISCILA 12662249242 NULL 12662249242 07269 DIPIRONA 500 MG/ML 2 ML SI IV IM AP 0.6900 0.6864 0.0036 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 6ccea6ac8c216c032723aee73a9f81c9 PRISCILA 12662249242 NULL 12662249242 20672 SORO RINGER SIMPLES 500 ML SI IV BS 5.9400 5.9375 0.0025 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00817 ALGODAO HIDROFILO BOLINHA UN 0.3800 0.1300 0.2500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 d17b3c5ae418d82694895a326dee545a ODILIA 12670516743 NULL 12670516743 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1774 0.0026 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 08664 ESPARADRAPO MICROPORE 50 X 10 CM CM 0.7700 0.2550 0.5150 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 19135 SERINGA DESC 03 ML UN 0.1500 0.0000 0.1500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 53660 EQUIPO MACRO-GOTAS FLEXIVEL C/ INJETOR LATE 1.5900 1.5900 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e2b254ce765be196b019032789d8f852 MARIA 12576216044 NULL 12576216044 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4078 0.0022 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 08664 ESPARADRAPO MICROPORE 50 X 10 CM CM 0.2600 0.2558 0.0042 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 08664 ESPARADRAPO MICROPORE 50 X 10 CM CM 0.2600 0.2558 0.0042 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 08664 ESPARADRAPO MICROPORE 50 X 10 CM CM 0.2600 0.2558 0.0042 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 11193 CLOREXIDINA 2 % ST TP ML 0.5300 0.5320 -0.0020 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1900 0.1779 0.0121 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1779 0.0021 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1779 0.0021 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 19160 SERINGA DESC 20 ML UN 1.0800 1.0744 0.0056 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 19160 SERINGA DESC 20 ML UN 0.5400 0.5372 0.0028 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 19160 SERINGA DESC 20 ML UN 0.5400 0.5372 0.0028 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 19160 SERINGA DESC 20 ML UN 0.5400 0.5372 0.0028 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 19160 SERINGA DESC 20 ML UN 0.5400 0.5372 0.0028 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 19160 SERINGA DESC 20 ML UN 0.5400 0.5372 0.0028 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8073 0.0027 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1769 0.0031 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1769 0.0031 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1769 0.0031 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 19160 SERINGA DESC 20 ML UN 0.5400 0.5375 0.0025 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 19160 SERINGA DESC 20 ML UN 0.5400 0.5375 0.0025 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 19160 SERINGA DESC 20 ML UN 0.5400 0.5375 0.0025 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 07269 DIPIRONA 500 MG/ML 2 ML SI IV IM AP 0.6900 0.6865 0.0035 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 07269 DIPIRONA 500 MG/ML 2 ML SI IV IM AP 0.6900 0.6865 0.0035 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 07269 DIPIRONA 500 MG/ML 2 ML SI IV IM AP 0.6900 0.6865 0.0035 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 07269 DIPIRONA 500 MG/ML 2 ML SI IV IM AP 0.6900 0.6865 0.0035 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4075 0.0025 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4075 0.0025 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4075 0.0025 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4075 0.0025 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 19445 CLORETO DE POTASSIO 600 MG CA VO UN 0.4900 0.4867 0.0033 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 32204 CLORETO DE SODIO 0,9% 10 ML SI IV AP 0.9600 0.9600 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 19160 SERINGA DESC 20 ML UN 0.5400 0.5384 0.0016 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 19160 SERINGA DESC 20 ML UN 0.5400 0.5384 0.0016 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 19160 SERINGA DESC 20 ML UN 0.5400 0.5384 0.0016 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 19160 SERINGA DESC 20 ML UN 0.5400 0.5384 0.0016 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 19160 SERINGA DESC 20 ML UN 0.5400 0.5384 0.0016 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 19160 SERINGA DESC 20 ML UN 0.5400 0.5384 0.0016 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 19160 SERINGA DESC 20 ML UN 0.5400 0.5384 0.0016 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 19160 SERINGA DESC 20 ML UN 0.5400 0.5384 0.0016 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 19160 SERINGA DESC 20 ML UN 0.5400 0.5384 0.0016 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4084 0.0016 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4084 0.0016 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4084 0.0016 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4084 0.0016 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1758 0.0042 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1758 0.0042 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1758 0.0042 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1758 0.0042 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 07269 DIPIRONA 500 MG/ML 2 ML SI IV IM AP 0.6900 0.6850 0.0050 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 27480 CLARITROMICINA 500 MG 30 ML PO IV FA 117.1100 117.1050 0.0050 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 27480 CLARITROMICINA 500 MG 30 ML PO IV FA 117.1100 117.1050 0.0050 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 00817 ALGODAO HIDROFILO BOLINHA UN 0.1300 0.0000 0.1300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 670141098c0309ac9be3db204bdc12cf LEOSINA 12706525442 NULL 12706525442 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1765 0.0035 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 b288bbcfb9aecab51bcb0dba62ca0059 IVONETE 12743730847 NULL 12743730847 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4067 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 05975 COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER 0.6000 0.1500 0.4500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 05975 COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER 0.3000 0.0000 0.3000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 08648 ESPARADRAPO 10 X 4.5 CM CM 0.4000 0.2000 0.2000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 05975 COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER 0.3000 0.0000 0.3000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 05975 COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER 0.3000 0.0000 0.3000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 20567 SORO FISIOLOGICO 0,9% 500 ML SI IV BS 4.7300 4.7350 -0.0050 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 08435 EQUIPO P/ BOMBA DE INFUSAO ENTERAL / PARENT 20.2800 20.2780 0.0020 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 08435 EQUIPO P/ BOMBA DE INFUSAO ENTERAL / PARENT 20.2800 20.2780 0.0020 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 08435 EQUIPO P/ BOMBA DE INFUSAO ENTERAL / PARENT 20.2800 20.2780 0.0020 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8091 0.0009 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.4000 0.4045 -0.0045 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.4000 0.4049 -0.0049 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1900 0.1797 0.0103 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1797 0.0003 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1797 0.0003 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 19160 SERINGA DESC 20 ML UN 0.5400 0.5378 0.0022 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1038 -0.0038 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1038 -0.0038 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1038 -0.0038 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 345c226bfea274af1372d41b0305a6c8 ALTINO 12720257940 NULL 12720257940 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1000 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 345c226bfea274af1372d41b0305a6c8 ALTINO 12720257940 NULL 12720257940 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1000 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1d6bbb4a00130e2e654e830fc9bae6a ALEXANDRINA 12694224940 NULL 12694224940 19160 SERINGA DESC 20 ML UN 0.5400 0.5367 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1d6bbb4a00130e2e654e830fc9bae6a ALEXANDRINA 12694224940 NULL 12694224940 00035 ABOCATH (CATETER INTRAVENOSO) N. 14 A 22 UN 11.3000 11.2900 0.0000 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 19160 SERINGA DESC 20 ML UN 0.5400 0.5372 0.0028 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 19160 SERINGA DESC 20 ML UN 0.5400 0.5372 0.0028 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 19160 SERINGA DESC 20 ML UN 0.5400 0.5372 0.0028 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 19160 SERINGA DESC 20 ML UN 0.5400 0.5372 0.0028 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 19160 SERINGA DESC 20 ML UN 0.5400 0.5372 0.0028 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 19160 SERINGA DESC 20 ML UN 0.5400 0.5372 0.0028 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 19160 SERINGA DESC 20 ML UN 0.5400 0.5372 0.0028 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 19160 SERINGA DESC 20 ML UN 0.5400 0.5372 0.0028 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 19160 SERINGA DESC 20 ML UN 0.5400 0.5372 0.0028 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 19160 SERINGA DESC 20 ML UN 0.5400 0.5372 0.0028 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4074 0.0026 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4074 0.0026 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 d4089ccef13567fd45b16fb0b60685fa VERA 12640482546 NULL 12640482546 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1754 0.0046 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 d4089ccef13567fd45b16fb0b60685fa VERA 12640482546 NULL 12640482546 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1754 0.0046 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 d4089ccef13567fd45b16fb0b60685fa VERA 12640482546 NULL 12640482546 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1754 0.0046 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 d4089ccef13567fd45b16fb0b60685fa VERA 12640482546 NULL 12640482546 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1754 0.0046 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 d4089ccef13567fd45b16fb0b60685fa VERA 12640482546 NULL 12640482546 27480 CLARITROMICINA 500 MG 30 ML PO IV FA 117.1100 117.1050 0.0050 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 d4089ccef13567fd45b16fb0b60685fa VERA 12640482546 NULL 12640482546 27480 CLARITROMICINA 500 MG 30 ML PO IV FA 117.1100 117.1050 0.0050 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 d4089ccef13567fd45b16fb0b60685fa VERA 12640482546 NULL 12640482546 27480 CLARITROMICINA 500 MG 30 ML PO IV FA 117.1100 117.1050 0.0050 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 d4089ccef13567fd45b16fb0b60685fa VERA 12640482546 NULL 12640482546 27480 CLARITROMICINA 500 MG 30 ML PO IV FA 117.1100 117.1050 0.0050 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 f93cee6f501560245a8f94ffc5c6c246 ROSEDALIA 12622895145 NULL 12622895145 19160 SERINGA DESC 20 ML UN 0.5400 0.5373 0.0027 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 c2bcdc3cbedb73a0db271ac09d4587a1 ORDETE 12694018147 NULL 12694018147 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1760 0.0040 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 c2bcdc3cbedb73a0db271ac09d4587a1 ORDETE 12694018147 NULL 12694018147 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1760 0.0040 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 f65f553befc0e3bc8bd5bce5c1c6e413 NAIRLENE 12633078944 NULL 12633078944 07269 DIPIRONA 500 MG/ML 2 ML SI IV IM AP 0.6900 0.6867 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 f65f553befc0e3bc8bd5bce5c1c6e413 NAIRLENE 12633078944 NULL 12633078944 07269 DIPIRONA 500 MG/ML 2 ML SI IV IM AP 0.6900 0.6867 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 f65f553befc0e3bc8bd5bce5c1c6e413 NAIRLENE 12633078944 NULL 12633078944 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1760 0.0040 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 f65f553befc0e3bc8bd5bce5c1c6e413 NAIRLENE 12633078944 NULL 12633078944 33219 LUVA DE PROCEDIMENTO UNIDADE UN 1.6700 1.6650 0.0050 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 7c2bc8cd9bbf9ce081562a3c63fff8c9 MARTA 12647505849 NULL 12647505849 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1756 0.0044 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 7c2bc8cd9bbf9ce081562a3c63fff8c9 MARTA 12647505849 NULL 12647505849 22896 CEFUROXIMA 750 MG + DIL. 6 ML PO IM IV FA 26.1300 26.1250 0.0050 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 37761 ALCOOL ETILICO 70 % ST TP ML 0.0300 0.0200 0.0100 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 37761 ALCOOL ETILICO 70 % ST TP ML 0.0300 0.0200 0.0100 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 37761 ALCOOL ETILICO 70 % ST TP ML 0.0300 0.0200 0.0100 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 32891 EQUIPO POLIFIX 2ş VIAS UN 2.5500 0.0000 2.5500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00817 ALGODAO HIDROFILO BOLINHA UN 0.2600 0.1300 0.1300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12558131243 NULL 12558131243 08664 ESPARADRAPO MICROPORE 50 X 10 CM CM 0.7700 0.2600 0.5100 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12558131243 NULL 12558131243 11193 CLOREXIDINA 2 % ST TP ML 0.5300 0.2700 0.2600 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12558131243 NULL 12558131243 11193 CLOREXIDINA 2 % ST TP ML 0.5300 0.2700 0.2600 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12558131243 NULL 12558131243 11193 CLOREXIDINA 2 % ST TP ML 0.5300 0.2700 0.2600 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12558131243 NULL 12558131243 08664 ESPARADRAPO MICROPORE 50 X 10 CM CM 0.7700 0.2600 0.5100 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1900 0.0000 0.1900 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 18457 REPARIL (ESCINA + DIETILAMONIO) GL TP GR 3.7500 0.0000 3.7500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 55018 ALGINATO DE CALCIO EM HIDROGEL GL TP GR 6.9000 3.4500 3.4500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 37761 ALCOOL ETILICO 70 % ST TP ML 0.0300 0.0200 0.0100 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 37761 ALCOOL ETILICO 70 % ST TP ML 0.0300 0.0200 0.0100 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 28959 DERSANI LC TP ML 19.4000 9.7000 9.7000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 05975 COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER 0.3000 0.0000 0.3000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 33219 LUVA DE PROCEDIMENTO UNIDADE UN 1.0000 0.6700 0.3300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 37761 ALCOOL ETILICO 70 % ST TP ML 0.0300 0.0200 0.0100 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 00817 ALGODAO HIDROFILO BOLINHA UN 0.2600 0.1300 0.1300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 00817 ALGODAO HIDROFILO BOLINHA UN 0.2600 0.1300 0.1300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 20567 SORO FISIOLOGICO 0,9% 500 ML SI IV BS 4.7300 0.0000 4.7300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 11193 CLOREXIDINA 2 % ST TP ML 0.5300 0.0000 0.5300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 4668d2494ed6c4b2d18be299efcb26a2 JOAO 12469689344 NULL 12469689344 08648 ESPARADRAPO 10 X 4.5 CM CM 0.4000 0.2600 0.1400 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 75bcd473a0dc7c7a6751499b38a4a034 JOAQUIM 12692852143 NULL 12692852143 37761 ALCOOL ETILICO 70 % ST TP ML 0.0300 0.0200 0.0100 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 75bcd473a0dc7c7a6751499b38a4a034 JOAQUIM 12692852143 NULL 12692852143 08648 ESPARADRAPO 10 X 4.5 CM CM 0.4000 0.1000 0.3000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 37761 ALCOOL ETILICO 70 % ST TP ML 0.0300 0.0200 0.0100 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 37761 ALCOOL ETILICO 70 % ST TP ML 0.0600 0.0200 0.0400 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 33219 LUVA DE PROCEDIMENTO UNIDADE UN 1.6700 0.6700 1.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 37761 ALCOOL ETILICO 70 % ST TP ML 0.0600 0.0200 0.0400 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 33219 LUVA DE PROCEDIMENTO UNIDADE UN 1.6700 0.6700 1.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 08648 ESPARADRAPO 10 X 4.5 CM CM 0.4000 0.2000 0.2000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 37761 ALCOOL ETILICO 70 % ST TP ML 0.0600 0.0200 0.0400 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 33219 LUVA DE PROCEDIMENTO UNIDADE UN 1.0000 0.6700 0.3300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 33219 LUVA DE PROCEDIMENTO UNIDADE UN 1.0000 0.6700 0.3300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 08648 ESPARADRAPO 10 X 4.5 CM CM 0.4000 0.2000 0.2000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 33219 LUVA DE PROCEDIMENTO UNIDADE UN 1.0000 0.6700 0.3300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 b288bbcfb9aecab51bcb0dba62ca0059 IVONETE 12743730847 NULL 12743730847 57495 FILTRO BARREIRA E REGENERADOR DE CALOR E UM 24.0000 0.0000 24.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd6f8d6c53ffe9bfd3aa9590ba500cc8 ILDA 12751932542 NULL 12751932542 08664 ESPARADRAPO MICROPORE 50 X 10 CM CM 0.7700 0.0000 0.7700 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd6f8d6c53ffe9bfd3aa9590ba500cc8 ILDA 12751932542 NULL 12751932542 08664 ESPARADRAPO MICROPORE 50 X 10 CM CM 1.5400 0.5100 1.0300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 01081195 ea21814027c9a23a6af0dd86f5bd1998 BENEDITA 12751372213 NULL 12751372213 00010014 CONSULTA EM CONSULTORIO MEDICO 0.0000 0.0000 50.0000 GUIA DE CONSULTA NAO EXECUTADA 0622
Glosa Min 2018-10-03 00:00:00.000000 01081195 68c12713747b34e80e50b5a3bd2dc90e SISSI 12748889510 NULL 12748889510 00010014 CONSULTA EM CONSULTORIO MEDICO 0.0000 0.0000 50.0000 GUIA DE CONSULTA NAO EXECUTADA 0622
Glosa Min 2018-10-03 00:00:00.000000 1084117 345c226bfea274af1372d41b0305a6c8 ALTINO 12720257940 NULL 12720257940 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1000 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 345c226bfea274af1372d41b0305a6c8 ALTINO 12720257940 NULL 12720257940 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1000 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 345c226bfea274af1372d41b0305a6c8 ALTINO 12720257940 NULL 12720257940 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1000 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 345c226bfea274af1372d41b0305a6c8 ALTINO 12720257940 NULL 12720257940 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1750 0.0050 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 345c226bfea274af1372d41b0305a6c8 ALTINO 12720257940 NULL 12720257940 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1750 0.0050 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 345c226bfea274af1372d41b0305a6c8 ALTINO 12720257940 NULL 12720257940 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1750 0.0050 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 345c226bfea274af1372d41b0305a6c8 ALTINO 12720257940 NULL 12720257940 07269 DIPIRONA 500 MG/ML 2 ML SI IV IM AP 0.6900 0.6860 0.0040 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 345c226bfea274af1372d41b0305a6c8 ALTINO 12720257940 NULL 12720257940 13404 OMEPRAZOL 40 MG + DIL. 10 ML PO IV FA 19.5800 19.5750 0.0050 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 0405a686318e3fc262f105ed4be24d95 CARMELITA 12687161644 NULL 12687161644 33227 LUVA CIRURGICA PAR UN 1.4500 1.4400 0.0000 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 0405a686318e3fc262f105ed4be24d95 CARMELITA 12687161644 NULL 12687161644 19160 SERINGA DESC 20 ML UN 0.5400 0.5367 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 ea6abb4182a48f0934f3e9eb5affa056 DILVA 12697455440 NULL 12697455440 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1750 0.0050 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 27600 ONDANSETRONA 2 MG/ML 4 ML SI IM IV AP 13.5300 0.0000 13.5300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 27600 ONDANSETRONA 2 MG/ML 4 ML SI IM IV AP 13.5300 0.0000 13.5300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 33219 LUVA DE PROCEDIMENTO UNIDADE UN 0.6700 0.6700 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 27600 ONDANSETRONA 2 MG/ML 4 ML SI IM IV AP 13.5300 0.0000 13.5300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 11193 CLOREXIDINA 2 % ST TP ML 0.8000 0.7972 0.0028 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 27600 ONDANSETRONA 2 MG/ML 4 ML SI IM IV AP 13.5300 0.0000 13.5300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 27600 ONDANSETRONA 2 MG/ML 4 ML SI IM IV AP 13.5300 0.0000 13.5300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 11193 CLOREXIDINA 2 % ST TP ML 0.8000 0.7972 0.0028 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 01496 FENITOINA 50 MG/ML 5 ML SI IM IV AP 0.0000 2.3400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00128 LUVA DE PROCEDIMENTO UNIDADE UN 0.0000 1.6700 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 35382 COMPRESSAS DE GASES 7.5 X7,5 (11 FIOS ESTERIL) UN 0.0000 0.6000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6874 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6874 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6874 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6874 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6874 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6874 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6874 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6874 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6874 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 52392 SONDA DE ASPIRAÇAO TRAQUEAL C/ VALVULA UN 0.0000 0.9352 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 52392 SONDA DE ASPIRAÇAO TRAQUEAL C/ VALVULA UN 0.0000 0.9352 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 52392 SONDA DE ASPIRAÇAO TRAQUEAL C/ VALVULA UN 0.0000 0.9352 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 51649 ALCOOL ETILICO 70 % ST TP ML 0.0000 0.0000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 51590 ABAIXADOR DE LINGUA UN 0.0000 0.0500 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 51241 AGULHA 123X45 0.0000 0.1900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 51241 AGULHA 123X45 0.0000 0.1900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 51241 AGULHA 123X45 0.0000 0.1900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 51241 AGULHA 123X45 0.0000 0.1900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 51241 AGULHA 123X45 0.0000 0.1900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 51241 AGULHA 123X45 0.0000 0.1900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 51241 AGULHA 123X45 0.0000 0.1900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1752 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1752 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1752 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1752 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1752 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.4000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.4000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 35382 COMPRESSAS DE GASES 7.5 X7,5 (11 FIOS ESTERIL) UN 0.0000 0.0900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4094 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 00128 LUVA DE PROCEDIMENTO UNIDADE UN 0.0000 1.6700 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 00124 LUVA CIRURGICA UN 0.0000 1.4482 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 00124 LUVA CIRURGICA UN 0.0000 1.4482 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 00124 LUVA CIRURGICA UN 0.0000 1.4482 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 00124 LUVA CIRURGICA UN 0.0000 1.4500 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 00124 LUVA CIRURGICA UN 0.0000 1.4482 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 00124 LUVA CIRURGICA UN 0.0000 1.4500 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 00124 LUVA CIRURGICA UN 0.0000 1.4500 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 51584 ESPARADRAPO MICROPORE 0.0000 0.2600 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 51584 ESPARADRAPO MICROPORE 0.0000 0.2600 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 35382 COMPRESSAS DE GASES 7.5 X7,5 (11 FIOS ESTERIL) UN 0.0000 0.3000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 25040014 Fisioterapia Respiratória - em Doente Clínico Internado 0.0000 10.0600 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 00124 LUVA CIRURGICA UN 0.0000 1.4476 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 00090 SERINGA DESC 20 ML UN 0.0000 0.5376 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 00090 SERINGA DESC 20 ML UN 0.0000 0.5376 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 00090 SERINGA DESC 20 ML UN 0.0000 0.5376 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 00090 SERINGA DESC 20 ML UN 0.0000 0.5376 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 00090 SERINGA DESC 20 ML UN 0.0000 0.5376 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1775 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1775 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1775 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1775 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1775 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 25040014 Fisioterapia Respiratória - em Doente Clínico Internado 0.0000 10.0600 NULL EXAME NAO AUTORIZADO 2707
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4074 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4074 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4074 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 00124 LUVA CIRURGICA UN 0.0000 1.4500 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 00124 LUVA CIRURGICA UN 0.0000 1.4473 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00090 SERINGA DESC 20 ML UN 0.0000 0.5387 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00090 SERINGA DESC 20 ML UN 0.0000 0.5387 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00090 SERINGA DESC 20 ML UN 0.0000 0.5387 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00090 SERINGA DESC 20 ML UN 0.0000 0.5387 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00090 SERINGA DESC 20 ML UN 0.0000 0.5387 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00090 SERINGA DESC 20 ML UN 0.0000 0.5387 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00090 SERINGA DESC 20 ML UN 0.0000 0.5387 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00090 SERINGA DESC 20 ML UN 0.0000 0.5387 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00090 SERINGA DESC 20 ML UN 0.0000 0.5387 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00090 SERINGA DESC 20 ML UN 0.0000 0.5387 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00090 SERINGA DESC 20 ML UN 0.0000 0.5387 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00090 SERINGA DESC 20 ML UN 0.0000 0.5387 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00090 SERINGA DESC 20 ML UN 0.0000 0.5387 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00090 SERINGA DESC 20 ML UN 0.0000 0.5387 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00090 SERINGA DESC 20 ML UN 0.0000 0.5387 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00090 SERINGA DESC 20 ML UN 0.0000 0.5400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1766 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1766 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4088 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4088 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4088 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4088 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00943 EQUIPO POLIFIX 2 VIAS UN 0.0000 2.5500 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00090 SERINGA DESC 20 ML UN 0.0000 0.5400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00090 SERINGA DESC 20 ML UN 0.0000 0.5400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 24082 BROMOPRIDA 5 MG/ML 2 ML SI IM IV AP 0.0000 2.7300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 24082 BROMOPRIDA 5 MG/ML 2 ML SI IM IV AP 0.0000 2.7300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00170 SORO GLICOSADO 5% 250 ML SI IV BS 0.0000 3.4000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 01584 NEOSTIGMINA 0,5 MG/ML 1 ML SI IM IV SC AP 0.0000 0.7667 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 01584 NEOSTIGMINA 0,5 MG/ML 1 ML SI IM IV SC AP 0.0000 0.7667 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 01584 NEOSTIGMINA 0,5 MG/ML 1 ML SI IM IV SC AP 0.0000 0.7667 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 01584 NEOSTIGMINA 0,5 MG/ML 1 ML SI IM IV SC AP 0.0000 0.7667 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 01584 NEOSTIGMINA 0,5 MG/ML 1 ML SI IM IV SC AP 0.0000 0.7667 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4062 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4062 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4062 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4062 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4062 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4062 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00124 LUVA CIRURGICA UN 0.0000 1.4475 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00919 ALGODAO HIDROFILO BOLINHA UN 0.0000 0.0000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00090 SERINGA DESC 20 ML UN 0.0000 0.0000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 09071 ACETILCISTEINA 600MG PO VO SA 0.0000 3.4950 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 09071 ACETILCISTEINA 600MG PO VO SA 0.0000 3.4950 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 09071 ACETILCISTEINA 600MG PO VO SA 0.0000 3.4950 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 08829 Bricanyl 0,5mg Inj. Ampola C/ 1ml 0.0000 7.1800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 08829 Bricanyl 0,5mg Inj. Ampola C/ 1ml 0.0000 3.5900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 08829 Bricanyl 0,5mg Inj. Ampola C/ 1ml 0.0000 3.5900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 07802 PIPERACILINA 4 G + TAZOBACTAM 500 MG PO IV FA 0.0000 83.4500 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 07802 PIPERACILINA 4 G + TAZOBACTAM 500 MG PO IV FA 0.0000 83.4500 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00735 CEFTRIAXONA IV 1G + DIL. 10 ML PO IV FA 0.0000 54.1300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00735 CEFTRIAXONA IV 1G + DIL. 10 ML PO IV FA 0.0000 54.1300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00735 CEFTRIAXONA IV 1G + DIL. 10 ML PO IV FA 0.0000 27.0600 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00069 SERINGA DESC 10 ML UN 0.0000 0.0000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00613 CLINDAMICINA 600 MG 4 ML SI IM IV AP 0.0000 13.0800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00613 CLINDAMICINA 600 MG 4 ML SI IM IV AP 0.0000 13.0800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 26981 SORO FISIOLOGICO 0,9% 10 ML SI IV AP 0.0000 0.9600 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 02246 HIDROCORTISONA 100 MG PO IM IV FA 0.0000 5.6700 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 02246 HIDROCORTISONA 100 MG PO IM IV FA 0.0000 5.6700 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 02246 HIDROCORTISONA 100 MG PO IM IV FA 0.0000 2.8300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 02246 HIDROCORTISONA 100 MG PO IM IV FA 0.0000 2.8300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 02246 HIDROCORTISONA 100 MG PO IM IV FA 0.0000 0.0000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00172 SORO FISIOLOGICO 0,9% 500 ML SI IV BS 0.0000 4.7300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4075 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 01230 FLEET ENEMA (FOSFATO DE SODIO DIBASICO + FOSFATO FR 0.0000 10.2500 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 11700 EQUIPO P/ BOMBA DE INFUSAO ENTERAL / PARENTERAL 0.0000 20.2800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 11700 EQUIPO P/ BOMBA DE INFUSAO ENTERAL / PARENTERAL 0.0000 20.2800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 800720d33fe0defb6121e82dd216d044 JALMO 12786952647 NULL 12786952647 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 800720d33fe0defb6121e82dd216d044 JALMO 12786952647 NULL 12786952647 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 05975 COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER 0.7739 0.8051 -0.7751 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 11193 CLOREXIDINA 2 % ST TP ML 0.5300 0.5320 -0.0020 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 11193 CLOREXIDINA 2 % ST TP ML 0.5300 0.5320 -0.0020 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 07269 DIPIRONA 500 MG/ML 2 ML SI IV IM AP 0.6900 0.6860 0.0040 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 13935 METAMUCIL (PLANTAGO OVATA) 5,85 G PO VO E 4.9236 7.3907 -4.9307 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 19151 SERINGA DESC 10 ML UN 0.3300 0.6669 -0.3369 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 19151 SERINGA DESC 10 ML UN 0.3300 0.6669 -0.3369 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 19151 SERINGA DESC 10 ML UN 0.3300 0.6669 -0.3369 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 19151 SERINGA DESC 10 ML UN 0.3300 0.6669 -0.3369 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 19151 SERINGA DESC 10 ML UN 0.3300 0.6669 -0.3369 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 19151 SERINGA DESC 10 ML UN 0.3300 0.6669 -0.3369 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 19151 SERINGA DESC 10 ML UN 0.3300 0.6669 -0.3369 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 19151 SERINGA DESC 10 ML UN 0.3300 0.6669 -0.3369 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 19151 SERINGA DESC 10 ML UN 0.3300 0.6669 -0.3369 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 19151 SERINGA DESC 10 ML UN 0.6634 1.0003 -0.6703 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 19151 SERINGA DESC 10 ML UN 0.6634 1.0003 -0.6703 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 19151 SERINGA DESC 10 ML UN 0.6634 1.0003 -0.6703 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 31585 RANITIDINA 25 MG/ML 2 ML SI IV IM AP 0.9300 0.9334 -0.0034 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 31585 RANITIDINA 25 MG/ML 2 ML SI IV IM AP 0.9300 0.9334 -0.0034 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 31585 RANITIDINA 25 MG/ML 2 ML SI IV IM AP 0.9300 0.9334 -0.0034 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 31585 RANITIDINA 25 MG/ML 2 ML SI IV IM AP 0.9300 1.8668 -0.9368 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 07587 DRAMIN B6 DL (DIMENIDRINATO + PIRIDOXINA + 11.0637 13.2805 -11.0705 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 19445 CLORETO DE POTASSIO 600 MG CA VO UN 0.9768 1.4605 -0.9705 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 19445 CLORETO DE POTASSIO 600 MG CA VO UN 0.9768 1.4605 -0.9705 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 19445 CLORETO DE POTASSIO 600 MG CA VO UN 0.9768 1.4605 -0.9705 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 27596 TIRA TESTE PARA GLICOSE UN 1.0400 1.0400 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 27596 TIRA TESTE PARA GLICOSE UN 1.0400 2.0800 -1.0400 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 34827 TIORFAN (RACECADOTRILA) 100 MG CA VO UN 3.2000 6.4000 -3.2000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1060 -0.0060 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1060 -0.0060 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1060 -0.0060 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1060 -0.0060 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1060 -0.0060 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1060 -0.0060 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1060 -0.0060 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.2120 -0.1120 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.2120 -0.1120 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.2120 -0.1120 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.2120 -0.1120 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.2120 -0.1120 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.2120 -0.1120 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.2120 -0.1120 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.2120 -0.1120 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.2120 -0.1120 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.2120 -0.1120 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.2120 -0.1120 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.0000 0.1000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00817 ALGODAO HIDROFILO BOLINHA UN 0.2600 0.1300 0.1300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.0000 0.1000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 08648 ESPARADRAPO 10 X 4.5 CM CM 0.4000 0.0000 0.4000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.0000 0.8100 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 13935 METAMUCIL (PLANTAGO OVATA) 5,85 G PO VO E 2.4600 0.0000 2.4600 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 51162 AGUA BIDESTILADA 10 ML SI IM IV AP NULL 0.0000 NULL OPME INVALIDO 2201
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 000435 TAXA DE RESPIRADOR A VOLUME (MAI) NULL 0.0000 NULL OPME INVALIDO 2201
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 27060055 UNID EM AFERESE CONCENTRADO DE PLAQUETAS NULL 0.0000 NULL OPME INVALIDO 2201
Glosa Min 2018-10-03 00:00:00.000000 01081195 33f0e59d5bdeccc8917e028ac50ea028 NILZA 12811264813 NULL 12811264813 00010014 CONSULTA EM CONSULTORIO MEDICO 0.0000 0.0000 50.0000 GUIA DE CONSULTA NAO EXECUTADA 0622
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 37761 ALCOOL ETILICO 70 % ST TP ML 0.0600 0.0300 0.0300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 19119 SERINGA DESC 01 ML (INSULINA) UN 0.6100 0.0000 0.6100 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 00817 ALGODAO HIDROFILO BOLINHA UN 0.5100 0.2600 0.2500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 02720 BOLSA COLETORA (SISTEMA ABERTO) UN 1.2800 0.6400 0.6400 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 08648 ESPARADRAPO 10 X 4.5 CM CM 0.4000 0.2000 0.2000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 02720 BOLSA COLETORA (SISTEMA ABERTO) UN 1.2800 0.6400 0.6400 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 28959 DERSANI LC TP ML 19.4000 14.5500 4.8500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 00817 ALGODAO HIDROFILO BOLINHA UN 0.5100 0.2600 0.2500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 d17b3c5ae418d82694895a326dee545a ODILIA 12670516743 NULL 12670516743 33219 LUVA DE PROCEDIMENTO UNIDADE UN 1.0000 0.6700 0.3300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 d17b3c5ae418d82694895a326dee545a ODILIA 12670516743 NULL 12670516743 08648 ESPARADRAPO 10 X 4.5 CM CM 0.4000 0.2000 0.2000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 d17b3c5ae418d82694895a326dee545a ODILIA 12670516743 NULL 12670516743 37761 ALCOOL ETILICO 70 % ST TP ML 0.0600 0.0200 0.0400 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 d17b3c5ae418d82694895a326dee545a ODILIA 12670516743 NULL 12670516743 05975 COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER 0.6000 0.3800 0.2200 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 d17b3c5ae418d82694895a326dee545a ODILIA 12670516743 NULL 12670516743 37761 ALCOOL ETILICO 70 % ST TP ML 0.0300 0.0200 0.0100 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 d17b3c5ae418d82694895a326dee545a ODILIA 12670516743 NULL 12670516743 00817 ALGODAO HIDROFILO BOLINHA UN 0.2600 0.1300 0.1300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 d17b3c5ae418d82694895a326dee545a ODILIA 12670516743 NULL 12670516743 00817 ALGODAO HIDROFILO BOLINHA UN 0.2600 0.1300 0.1300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 d17b3c5ae418d82694895a326dee545a ODILIA 12670516743 NULL 12670516743 30376 BROMETO DE IPRATROPIO 0,25MG/ML SL IN GT 0.0200 0.0000 0.0200 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 d17b3c5ae418d82694895a326dee545a ODILIA 12670516743 NULL 12670516743 05975 COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER 0.6000 0.3800 0.2200 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 00817 ALGODAO HIDROFILO BOLINHA UN 0.5100 0.1300 0.3800 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 526685c1041cc1316e874a2e95e67e2e JOSE 12696604949 NULL 12696604949 55956 CARGA GRAMPEADOR 45MM 6 LINHAS UN 4102.5000 3418.7500 683.7500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 19151 SERINGA DESC 10 ML UN 0.3300 0.0000 0.3300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 19160 SERINGA DESC 20 ML UN 0.5400 0.0000 0.5400 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.0000 0.1800 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 02720 BOLSA COLETORA (SISTEMA ABERTO) UN 1.2800 0.6400 0.6400 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00485 AGUA BIDESTILADA 500 ML SI IM IV BS 6.4300 0.0000 6.4300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00485 AGUA BIDESTILADA 500 ML SI IM IV BS 6.4300 0.0000 6.4300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 57495 FILTRO BARREIRA E REGENERADOR DE CALOR E UM 24.0000 0.0000 24.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 02720 BOLSA COLETORA (SISTEMA ABERTO) UN 1.2800 0.6400 0.6400 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 02739 BOLSA COLETORA (SISTEMA FECHADO) UN 5.9300 0.0000 5.9300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 52582 CATETER OXIGENIO TIPO OCULOS UN 1.0000 0.0000 1.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 37761 ALCOOL ETILICO 70 % ST TP ML 0.0600 0.0300 0.0300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 57495 FILTRO BARREIRA E REGENERADOR DE CALOR E UM 24.0000 0.0000 24.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 752c651cb4fd049e19c685f87fbe8bdc EDUARDO 12765990646 NULL 12765990646 37761 ALCOOL ETILICO 70 % ST TP ML 0.0300 0.0200 0.0100 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 08648 ESPARADRAPO 10 X 4.5 CM CM 0.4000 0.2000 0.2000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 08648 ESPARADRAPO 10 X 4.5 CM CM 0.4000 0.2000 0.2000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 31828 PREDNISONA 20 MG CP VO UN 4.4900 1.5000 2.9900 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00817 ALGODAO HIDROFILO BOLINHA UN 0.2600 0.1300 0.1300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 37761 ALCOOL ETILICO 70 % ST TP ML 0.0300 0.0200 0.0100 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 33219 LUVA DE PROCEDIMENTO UNIDADE UN 1.0000 0.6700 0.3300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 22748 LIDOCAINA 2% GE TP OU GR 2.5900 1.3000 1.2900 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 08648 ESPARADRAPO 10 X 4.5 CM CM 0.4000 0.2000 0.2000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 345c226bfea274af1372d41b0305a6c8 ALTINO 12720257940 NULL 12720257940 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1000 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 345c226bfea274af1372d41b0305a6c8 ALTINO 12720257940 NULL 12720257940 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1000 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 01081195 e3e6c06b12de2f8beedcf029ac1083bc ROSANGELA 12641946612 NULL 12641946612 00010014 CONSULTA EM CONSULTORIO MEDICO 0.0000 50.0000 NULL ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 26981 SORO FISIOLOGICO 0,9% 10 ML SI IV AP 0.0000 0.9600 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 24082 BROMOPRIDA 5 MG/ML 2 ML SI IM IV AP 0.0000 2.7300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 24082 BROMOPRIDA 5 MG/ML 2 ML SI IM IV AP 0.0000 2.7300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 24082 BROMOPRIDA 5 MG/ML 2 ML SI IM IV AP 0.0000 2.7300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 24082 BROMOPRIDA 5 MG/ML 2 ML SI IM IV AP 0.0000 2.7300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 01584 NEOSTIGMINA 0,5 MG/ML 1 ML SI IM IV SC AP 0.0000 0.7662 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 01584 NEOSTIGMINA 0,5 MG/ML 1 ML SI IM IV SC AP 0.0000 0.7662 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 01496 FENITOINA 50 MG/ML 5 ML SI IM IV AP 0.0000 2.3400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 01496 FENITOINA 50 MG/ML 5 ML SI IM IV AP 0.0000 2.3400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 01496 FENITOINA 50 MG/ML 5 ML SI IM IV AP 0.0000 2.3400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 01081195 900c66260626ee704d2ca7bb91ae2f1c MARIA 12811696013 NULL 12811696013 00010014 CONSULTA EM CONSULTORIO MEDICO 0.0000 0.0000 35.0000 GUIA DE CONSULTA NAO EXECUTADA 0622
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 00817 ALGODAO HIDROFILO BOLINHA UN 0.2600 0.1300 0.1300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 37761 ALCOOL ETILICO 70 % ST TP ML 0.0300 0.0200 0.0100 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 37761 ALCOOL ETILICO 70 % ST TP ML 0.0300 0.0200 0.0100 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 08648 ESPARADRAPO 10 X 4.5 CM CM 0.4000 0.2000 0.2000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 33219 LUVA DE PROCEDIMENTO UNIDADE UN 1.6700 0.6700 1.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 37761 ALCOOL ETILICO 70 % ST TP ML 0.0600 0.0200 0.0400 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 33219 LUVA DE PROCEDIMENTO UNIDADE UN 1.6700 0.6700 1.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 57495 FILTRO BARREIRA E REGENERADOR DE CALOR E UM 24.0000 0.0000 24.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 37761 ALCOOL ETILICO 70 % ST TP ML 0.0300 0.0000 0.0300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 00817 ALGODAO HIDROFILO BOLINHA UN 0.2600 0.0000 0.2600 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 75bcd473a0dc7c7a6751499b38a4a034 JOAQUIM 12692852143 NULL 12692852143 37761 ALCOOL ETILICO 70 % ST TP ML 0.0300 0.0200 0.0100 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 75bcd473a0dc7c7a6751499b38a4a034 JOAQUIM 12692852143 NULL 12692852143 00817 ALGODAO HIDROFILO BOLINHA UN 0.2600 0.1300 0.1300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 75bcd473a0dc7c7a6751499b38a4a034 JOAQUIM 12692852143 NULL 12692852143 08664 ESPARADRAPO MICROPORE 50 X 10 CM CM 0.7700 0.0000 0.7700 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 4668d2494ed6c4b2d18be299efcb26a2 JOAO 12469689344 NULL 12469689344 11193 CLOREXIDINA 2 % ST TP ML 1.3300 0.2700 1.0600 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 32891 EQUIPO POLIFIX 2ş VIAS UN 2.5500 0.0000 2.5500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 33227 LUVA CIRURGICA PAR UN 1.4500 0.0000 1.4500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12603877940 NULL 12603877940 00817 ALGODAO HIDROFILO BOLINHA UN 0.1300 0.0000 0.1300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12603877940 NULL 12603877940 00434 AGUA BIDESTILADA 1000 ML SI IM IV BS 8.9000 0.0000 8.9000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 33219 LUVA DE PROCEDIMENTO UNIDADE UN 1.0000 0.6700 0.3300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 08435 EQUIPO P/ BOMBA DE INFUSAO ENTERAL / PARENT 20.2800 0.0000 20.2800 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 33219 LUVA DE PROCEDIMENTO UNIDADE UN 1.0000 0.6700 0.3300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 00817 ALGODAO HIDROFILO BOLINHA UN 0.2600 0.1300 0.1300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 32891 EQUIPO POLIFIX 2ş VIAS UN 5.1000 2.5500 2.5500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 11193 CLOREXIDINA 2 % ST TP ML 0.8000 0.0000 0.8000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00817 ALGODAO HIDROFILO BOLINHA UN 0.2600 0.1300 0.1300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00817 ALGODAO HIDROFILO BOLINHA UN 0.2600 0.1300 0.1300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 33219 LUVA DE PROCEDIMENTO UNIDADE UN 1.0000 0.6700 0.3300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 08648 ESPARADRAPO 10 X 4.5 CM CM 0.4000 0.0000 0.4000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 33219 LUVA DE PROCEDIMENTO UNIDADE UN 1.0000 0.6700 0.3300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 32891 EQUIPO POLIFIX 2ş VIAS UN 2.5500 0.0000 2.5500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 08664 ESPARADRAPO MICROPORE 50 X 10 CM CM 0.5100 0.3800 0.1300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12558131243 NULL 12558131243 37761 ALCOOL ETILICO 70 % ST TP ML 0.0600 0.0300 0.0300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 37761 ALCOOL ETILICO 70 % ST TP ML 0.0300 0.0200 0.0100 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 7c2bc8cd9bbf9ce081562a3c63fff8c9 MARTA 12647505849 NULL 12647505849 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1756 0.0044 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 f65f553befc0e3bc8bd5bce5c1c6e413 NAIRLENE 12633078944 NULL 12633078944 19160 SERINGA DESC 20 ML UN 0.5400 0.5367 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 f65f553befc0e3bc8bd5bce5c1c6e413 NAIRLENE 12633078944 NULL 12633078944 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4067 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 f65f553befc0e3bc8bd5bce5c1c6e413 NAIRLENE 12633078944 NULL 12633078944 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4067 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 f65f553befc0e3bc8bd5bce5c1c6e413 NAIRLENE 12633078944 NULL 12633078944 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1760 0.0040 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 c2bcdc3cbedb73a0db271ac09d4587a1 ORDETE 12694018147 NULL 12694018147 00817 ALGODAO HIDROFILO BOLINHA UN 0.1300 0.1200 0.0000 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 c2bcdc3cbedb73a0db271ac09d4587a1 ORDETE 12694018147 NULL 12694018147 33219 LUVA DE PROCEDIMENTO UNIDADE UN 1.0000 0.9900 0.0000 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 c2bcdc3cbedb73a0db271ac09d4587a1 ORDETE 12694018147 NULL 12694018147 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1760 0.0040 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 f93cee6f501560245a8f94ffc5c6c246 ROSEDALIA 12622895145 NULL 12622895145 19160 SERINGA DESC 20 ML UN 0.5400 0.5373 0.0027 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 d4089ccef13567fd45b16fb0b60685fa VERA 12640482546 NULL 12640482546 27480 CLARITROMICINA 500 MG 30 ML PO IV FA 117.1100 117.1050 0.0050 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 d4089ccef13567fd45b16fb0b60685fa VERA 12640482546 NULL 12640482546 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1754 0.0046 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 d4089ccef13567fd45b16fb0b60685fa VERA 12640482546 NULL 12640482546 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1754 0.0046 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4074 0.0026 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4074 0.0026 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4074 0.0026 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4074 0.0026 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4074 0.0026 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4074 0.0026 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 19160 SERINGA DESC 20 ML UN 0.5400 0.5372 0.0028 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 19160 SERINGA DESC 20 ML UN 0.5400 0.5372 0.0028 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 19160 SERINGA DESC 20 ML UN 0.5400 0.5372 0.0028 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 19160 SERINGA DESC 20 ML UN 0.5400 0.5372 0.0028 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 19160 SERINGA DESC 20 ML UN 0.5400 0.5372 0.0028 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 19160 SERINGA DESC 20 ML UN 0.5400 0.5372 0.0028 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 19160 SERINGA DESC 20 ML UN 0.5400 0.5372 0.0028 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1d6bbb4a00130e2e654e830fc9bae6a ALEXANDRINA 12694224940 NULL 12694224940 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4072 0.0028 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1d6bbb4a00130e2e654e830fc9bae6a ALEXANDRINA 12694224940 NULL 12694224940 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4072 0.0028 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1d6bbb4a00130e2e654e830fc9bae6a ALEXANDRINA 12694224940 NULL 12694224940 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4072 0.0028 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1d6bbb4a00130e2e654e830fc9bae6a ALEXANDRINA 12694224940 NULL 12694224940 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4072 0.0028 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1d6bbb4a00130e2e654e830fc9bae6a ALEXANDRINA 12694224940 NULL 12694224940 19160 SERINGA DESC 20 ML UN 0.5400 0.5358 0.0042 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1d6bbb4a00130e2e654e830fc9bae6a ALEXANDRINA 12694224940 NULL 12694224940 19160 SERINGA DESC 20 ML UN 0.5400 0.5367 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1d6bbb4a00130e2e654e830fc9bae6a ALEXANDRINA 12694224940 NULL 12694224940 19160 SERINGA DESC 20 ML UN 0.5400 0.5367 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1d6bbb4a00130e2e654e830fc9bae6a ALEXANDRINA 12694224940 NULL 12694224940 19160 SERINGA DESC 20 ML UN 0.5400 0.5367 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1d6bbb4a00130e2e654e830fc9bae6a ALEXANDRINA 12694224940 NULL 12694224940 19160 SERINGA DESC 20 ML UN 0.5400 0.5367 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 345c226bfea274af1372d41b0305a6c8 ALTINO 12720257940 NULL 12720257940 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1000 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 345c226bfea274af1372d41b0305a6c8 ALTINO 12720257940 NULL 12720257940 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1000 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 345c226bfea274af1372d41b0305a6c8 ALTINO 12720257940 NULL 12720257940 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1000 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1038 -0.0038 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1038 -0.0038 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1038 -0.0038 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1038 -0.0038 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1038 -0.0038 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 19160 SERINGA DESC 20 ML UN 0.5400 0.5384 0.0016 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 19160 SERINGA DESC 20 ML UN 0.5400 0.5378 0.0022 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 19160 SERINGA DESC 20 ML UN 0.5400 0.5378 0.0022 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 19160 SERINGA DESC 20 ML UN 0.5400 0.5378 0.0022 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 19160 SERINGA DESC 20 ML UN 0.5400 0.5378 0.0022 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1797 0.0003 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1797 0.0003 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1797 0.0003 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1900 0.1797 0.0103 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1900 0.1797 0.0103 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.4000 0.4045 -0.0045 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8091 0.0009 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 752c651cb4fd049e19c685f87fbe8bdc EDUARDO 12765990646 NULL 12765990646 33219 LUVA DE PROCEDIMENTO UNIDADE UN 4.3300 1.6700 2.6600 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 53660 EQUIPO MACRO-GOTAS FLEXIVEL C/ INJETOR LATE 1.5900 0.0000 1.5900 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 05975 COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER 0.3000 0.0000 0.3000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 05975 COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER 0.6000 0.1500 0.4500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 05975 COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER 0.3000 0.0000 0.3000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 d2d55454dccb89ec02f576d653ebb2aa IRACI 12693519245 NULL 12693519245 33219 LUVA DE PROCEDIMENTO UNIDADE UN 1.0000 0.9900 0.0000 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 670141098c0309ac9be3db204bdc12cf LEOSINA 12706525442 NULL 12706525442 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4000 0.0000 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 08435 EQUIPO P/ BOMBA DE INFUSAO ENTERAL / PARENT 60.8400 60.8300 0.0000 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 37761 ALCOOL ETILICO 70 % ST TP ML 0.0300 0.0000 0.0300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 27480 CLARITROMICINA 500 MG 30 ML PO IV FA 117.1100 117.1050 0.0050 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 27480 CLARITROMICINA 500 MG 30 ML PO IV FA 117.1100 117.1050 0.0050 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 27480 CLARITROMICINA 500 MG 30 ML PO IV FA 117.1100 117.1050 0.0050 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1758 0.0042 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1758 0.0042 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1758 0.0042 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1758 0.0042 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1758 0.0042 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1758 0.0042 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4084 0.0016 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4084 0.0016 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4084 0.0016 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 19160 SERINGA DESC 20 ML UN 0.5400 0.5384 0.0016 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 19445 CLORETO DE POTASSIO 600 MG CA VO UN 0.4900 0.4867 0.0033 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 19445 CLORETO DE POTASSIO 600 MG CA VO UN 0.4900 0.4867 0.0033 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4075 0.0025 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4075 0.0025 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4075 0.0025 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 07269 DIPIRONA 500 MG/ML 2 ML SI IV IM AP 0.6900 0.6865 0.0035 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 07269 DIPIRONA 500 MG/ML 2 ML SI IV IM AP 0.6900 0.6865 0.0035 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 07269 DIPIRONA 500 MG/ML 2 ML SI IV IM AP 0.6900 0.6865 0.0035 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 07269 DIPIRONA 500 MG/ML 2 ML SI IV IM AP 0.6900 0.6865 0.0035 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 07269 DIPIRONA 500 MG/ML 2 ML SI IV IM AP 0.6900 0.6865 0.0035 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 07269 DIPIRONA 500 MG/ML 2 ML SI IV IM AP 0.6900 0.6865 0.0035 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 07269 DIPIRONA 500 MG/ML 2 ML SI IV IM AP 0.6900 0.6865 0.0035 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 07269 DIPIRONA 500 MG/ML 2 ML SI IV IM AP 0.6900 0.6865 0.0035 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1769 0.0031 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1769 0.0031 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1769 0.0031 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8073 0.0027 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8073 0.0027 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 19160 SERINGA DESC 20 ML UN 0.5400 0.5372 0.0028 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 19160 SERINGA DESC 20 ML UN 0.5400 0.5372 0.0028 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 19160 SERINGA DESC 20 ML UN 0.5400 0.5372 0.0028 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 19160 SERINGA DESC 20 ML UN 0.5400 0.5372 0.0028 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 19160 SERINGA DESC 20 ML UN 0.5400 0.5372 0.0028 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 19160 SERINGA DESC 20 ML UN 0.5400 0.5372 0.0028 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 19160 SERINGA DESC 20 ML UN 0.5400 0.5372 0.0028 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1761 0.0039 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1779 0.0021 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1779 0.0021 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1779 0.0021 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1779 0.0021 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1779 0.0021 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1779 0.0021 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1779 0.0021 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 08664 ESPARADRAPO MICROPORE 50 X 10 CM CM 0.2600 0.2558 0.0042 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 08664 ESPARADRAPO MICROPORE 50 X 10 CM CM 0.2600 0.2558 0.0042 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e2b254ce765be196b019032789d8f852 MARIA 12576216044 NULL 12576216044 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4078 0.0022 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 19135 SERINGA DESC 03 ML UN 0.1500 0.0000 0.1500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 19135 SERINGA DESC 03 ML UN 0.1500 0.0000 0.1500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 53660 EQUIPO MACRO-GOTAS FLEXIVEL C/ INJETOR LATE 1.5900 0.0000 1.5900 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 19135 SERINGA DESC 03 ML UN 0.1500 0.0000 0.1500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 d17b3c5ae418d82694895a326dee545a ODILIA 12670516743 NULL 12670516743 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1774 0.0026 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 d17b3c5ae418d82694895a326dee545a ODILIA 12670516743 NULL 12670516743 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1774 0.0026 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 11193 CLOREXIDINA 2 % ST TP ML 3.2000 0.8000 2.4000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 20559 SORO FISIOLOGICO 0,9% 250 ML SI IV BS 11.8300 3.9400 7.8900 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00035 ABOCATH (CATETER INTRAVENOSO) N. 14 A 22 UN 11.3000 3.7700 7.5300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 6ccea6ac8c216c032723aee73a9f81c9 PRISCILA 12662249242 NULL 12662249242 20672 SORO RINGER SIMPLES 500 ML SI IV BS 5.9400 5.9375 0.0025 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 6ccea6ac8c216c032723aee73a9f81c9 PRISCILA 12662249242 NULL 12662249242 20672 SORO RINGER SIMPLES 500 ML SI IV BS 5.9400 5.9375 0.0025 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 6ccea6ac8c216c032723aee73a9f81c9 PRISCILA 12662249242 NULL 12662249242 07269 DIPIRONA 500 MG/ML 2 ML SI IV IM AP 0.6900 0.6864 0.0036 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 6ccea6ac8c216c032723aee73a9f81c9 PRISCILA 12662249242 NULL 12662249242 07269 DIPIRONA 500 MG/ML 2 ML SI IV IM AP 0.6900 0.6864 0.0036 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 6ccea6ac8c216c032723aee73a9f81c9 PRISCILA 12662249242 NULL 12662249242 19160 SERINGA DESC 20 ML UN 0.5400 0.5373 0.0027 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1000 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1000 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1000 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1000 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1000 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1000 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1000 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1000 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1000 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1000 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1000 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1000 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.3100 0.3000 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.4000 0.0000 0.4000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.0000 0.8100 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1766 0.0034 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 33227 LUVA CIRURGICA PAR UN 1.4500 1.4476 0.0024 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 33227 LUVA CIRURGICA PAR UN 1.4500 1.4476 0.0024 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 33227 LUVA CIRURGICA PAR UN 1.4500 1.4476 0.0024 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 19160 SERINGA DESC 20 ML UN 0.5400 0.5384 0.0016 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 19160 SERINGA DESC 20 ML UN 0.5400 0.5384 0.0016 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 32891 EQUIPO POLIFIX 2ş VIAS UN 2.5500 2.5500 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1776 0.0024 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1776 0.0024 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8092 0.0008 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8092 0.0008 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8092 0.0008 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 11193 CLOREXIDINA 2 % ST TP ML 0.5300 0.5300 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 11193 CLOREXIDINA 2 % ST TP ML 0.5300 0.5300 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 6799aa3de305405ab065aad5b599765c VANIR 12700232345 NULL 12700232345 07269 DIPIRONA 500 MG/ML 2 ML SI IV IM AP 0.6900 0.6870 0.0030 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 6799aa3de305405ab065aad5b599765c VANIR 12700232345 NULL 12700232345 07269 DIPIRONA 500 MG/ML 2 ML SI IV IM AP 0.6900 0.6870 0.0030 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 29661 NOREPINEFRINA 2 MG/ML 4 ML SI IV AP 37.9900 37.9850 0.0050 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8079 0.0021 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8079 0.0021 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 75bcd473a0dc7c7a6751499b38a4a034 JOAQUIM 12692852143 NULL 12692852143 37761 ALCOOL ETILICO 70 % ST TP ML 0.0300 0.0200 0.0100 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 610c198ec4c064687cf0524f147d3aed ROBERTO 12748814743 NULL 12748814743 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1767 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 610c198ec4c064687cf0524f147d3aed ROBERTO 12748814743 NULL 12748814743 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1767 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 610c198ec4c064687cf0524f147d3aed ROBERTO 12748814743 NULL 12748814743 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4083 0.0017 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 610c198ec4c064687cf0524f147d3aed ROBERTO 12748814743 NULL 12748814743 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4083 0.0017 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 610c198ec4c064687cf0524f147d3aed ROBERTO 12748814743 NULL 12748814743 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4083 0.0017 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 610c198ec4c064687cf0524f147d3aed ROBERTO 12748814743 NULL 12748814743 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4083 0.0017 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 00487 RANITIDINA 25 MG/ML 2 ML SI IM IV AP 0.0000 0.9300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12647284040 NULL 12647284040 08664 ESPARADRAPO MICROPORE 50 X 10 CM CM 0.7700 0.7667 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12647284040 NULL 12647284040 20567 SORO FISIOLOGICO 0,9% 500 ML SI IV BS 9.4700 9.4697 0.0003 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12647284040 NULL 12647284040 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4086 0.0014 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12647284040 NULL 12647284040 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4086 0.0014 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12647284040 NULL 12647284040 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4086 0.0014 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 01081195 89cf7f30a66e6c1645adaac3ceeb8c40 SELMA 12812118918 NULL 12812118918 00010014 CONSULTA EM CONSULTORIO MEDICO 0.0000 35.0000 NULL ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 2a44e66e1f44091701d47a8515178d89 DIVA 12747785048 NULL 12747785048 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1700 0.0000 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 b53746577aa9f227f1671c3aee8e9ec0 ITAJAYR 12708811845 NULL 12708811845 999999 DESPESAS HOSPITALARES DIVERSAS 1777.2500 917.8767 859.3733 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 6.8145 -3.4045 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 6.8145 -3.4045 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 6.8145 -3.4045 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 6.8145 -3.4045 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 6.8145 -3.4045 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 6.8145 -3.4045 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 6.8145 -3.4045 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4072 0.0028 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4072 0.0028 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4072 0.0028 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4072 0.0028 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.2100 -0.1100 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.2120 -0.1120 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.2120 -0.1120 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.2120 -0.1120 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 19160 SERINGA DESC 20 ML UN 0.5400 0.5374 0.0026 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 19160 SERINGA DESC 20 ML UN 0.5400 0.5374 0.0026 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 19160 SERINGA DESC 20 ML UN 0.5400 0.5374 0.0026 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 19160 SERINGA DESC 20 ML UN 0.5400 0.5374 0.0026 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.4000 0.4037 -0.0037 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.4000 0.4037 -0.0037 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.4000 0.4037 -0.0037 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.4000 0.4037 -0.0037 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8073 0.0027 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8073 0.0027 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8073 0.0027 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8073 0.0027 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8073 0.0027 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00434 AGUA BIDESTILADA 1000 ML SI IM IV BS 62.3000 71.2000 -62.3000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 09636 FLORATIL (SACCHAROMYCES BOULARDII) 200 MG P 4.4400 8.8851 -4.4451 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 09636 FLORATIL (SACCHAROMYCES BOULARDII) 200 MG P 4.4400 8.8851 -4.4451 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 09636 FLORATIL (SACCHAROMYCES BOULARDII) 200 MG P 4.4400 8.8851 -4.4451 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 09636 FLORATIL (SACCHAROMYCES BOULARDII) 200 MG P 4.4400 8.8851 -4.4451 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 05975 COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER 0.7739 0.8059 -0.7759 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 05975 COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER 1.3439 1.3948 -0.7948 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 05975 COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER 1.3439 1.3948 -0.7948 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 28959 DERSANI LC TP ML 13.5800 14.5500 -4.8500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 28959 DERSANI LC TP ML 13.5800 14.5500 -4.8500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 55018 ALGINATO DE CALCIO EM HIDROGEL GL TP GR 17.2500 17.2500 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 08664 ESPARADRAPO MICROPORE 50 X 10 CM CM 1.1064 1.1285 -0.8685 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 08664 ESPARADRAPO MICROPORE 50 X 10 CM CM 1.3564 1.3849 -0.8749 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 08664 ESPARADRAPO MICROPORE 50 X 10 CM CM 1.3564 1.3849 -0.8749 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 08664 ESPARADRAPO MICROPORE 50 X 10 CM CM 1.3564 1.3849 -0.8749 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 08664 ESPARADRAPO MICROPORE 50 X 10 CM CM 1.3564 1.3849 -0.8749 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1d6bbb4a00130e2e654e830fc9bae6a ALEXANDRINA 12694224940 NULL 12694224940 999999 INSUMOS 40080200 NULL 0.0000 NULL OPME INVALIDO 2201
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 03280 CLOREXIDINA 2 % ST TP ML NULL 0.0000 NULL OPME INVALIDO 2201
Glosa Min 2018-10-03 00:00:00.000000 1084117 800720d33fe0defb6121e82dd216d044 JALMO 12786952647 NULL 12786952647 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 800720d33fe0defb6121e82dd216d044 JALMO 12786952647 NULL 12786952647 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 800720d33fe0defb6121e82dd216d044 JALMO 12786952647 NULL 12786952647 00487 RANITIDINA 25 MG/ML 2 ML SI IM IV AP 0.0000 0.9300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 800720d33fe0defb6121e82dd216d044 JALMO 12786952647 NULL 12786952647 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 800720d33fe0defb6121e82dd216d044 JALMO 12786952647 NULL 12786952647 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 800720d33fe0defb6121e82dd216d044 JALMO 12786952647 NULL 12786952647 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 800720d33fe0defb6121e82dd216d044 JALMO 12786952647 NULL 12786952647 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 800720d33fe0defb6121e82dd216d044 JALMO 12786952647 NULL 12786952647 51588 ESPARADRAPO MICROPORE 50 X 10 CM CM 0.0000 1.5400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 800720d33fe0defb6121e82dd216d044 JALMO 12786952647 NULL 12786952647 00757 CEFUROXIMA 750 MG + DIL. 6 ML PO IM IV FA 0.0000 26.1300 NULL VALOR APRESENTADO A MAIOR 1705
Glosa Min 2018-10-03 00:00:00.000000 1084117 800720d33fe0defb6121e82dd216d044 JALMO 12786952647 NULL 12786952647 00090 SERINGA DESC 20 ML UN 0.0000 0.5400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 800720d33fe0defb6121e82dd216d044 JALMO 12786952647 NULL 12786952647 00090 SERINGA DESC 20 ML UN 0.0000 0.5400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 752c651cb4fd049e19c685f87fbe8bdc EDUARDO 12765990646 NULL 12765990646 00172 SORO FISIOLOGICO 0,9% 500 ML SI IV BS 0.0000 9.4700 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 752c651cb4fd049e19c685f87fbe8bdc EDUARDO 12765990646 NULL 12765990646 00172 SORO FISIOLOGICO 0,9% 500 ML SI IV BS 0.0000 9.4700 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 752c651cb4fd049e19c685f87fbe8bdc EDUARDO 12765990646 NULL 12765990646 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 752c651cb4fd049e19c685f87fbe8bdc EDUARDO 12765990646 NULL 12765990646 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6875 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 752c651cb4fd049e19c685f87fbe8bdc EDUARDO 12765990646 NULL 12765990646 53975 Hemifumarato De Quetiapina 25mg ? Cp 0.0000 1.2450 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 752c651cb4fd049e19c685f87fbe8bdc EDUARDO 12765990646 NULL 12765990646 54995 EQUIPO P/ BOMBA DE INFUSAO ENTERAL / PARENTERAL U UN 0.0000 0.0000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12558131243 NULL 12558131243 00172 SORO FISIOLOGICO 0,9% 500 ML SI IV BS 0.0000 9.4700 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12558131243 NULL 12558131243 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1758 NULL VALOR APRESENTADO A MAIOR 1705
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12558131243 NULL 12558131243 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1757 NULL VALOR APRESENTADO A MAIOR 1705
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12558131243 NULL 12558131243 52010341 Hérnia Discal - Tratamento Cirúrgico 0.0000 0.0000 NULL COBRANCA DE HONORARIOS EM DUPLICIDADE 2607
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12558131243 NULL 12558131243 52010511 Fratura do Cóccix - Tratamento Cruento 0.0000 0.0000 NULL COBRANCA DE HONORARIOS EM DUPLICIDADE 2607
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12558131243 NULL 12558131243 52010511 Fratura do Cóccix - Tratamento Cruento 0.0000 0.0000 NULL COBRANCA DE HONORARIOS EM DUPLICIDADE 2607
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12558131243 NULL 12558131243 52010511 Fratura do Cóccix - Tratamento Cruento 0.0000 0.0000 NULL COBRANCA DE HONORARIOS EM DUPLICIDADE 2607
Glosa Min 2018-10-03 00:00:00.000000 1084117 526685c1041cc1316e874a2e95e67e2e JOSE 12696604949 NULL 12696604949 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1760 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 11232 CLEXANE (ENOXAPARINA) 40 MG SI IV SC SE 0.0000 38.9400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 11232 CLEXANE (ENOXAPARINA) 40 MG SI IV SC SE 0.0000 38.9400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 11325 EQUIPO MACRO-GOTAS FLEXIVEL C/ INJETOR LATERAL UN 0.0000 4.7700 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00404 LACTULOSE 667 MG/ML XP VO ML 0.0000 4.2900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.0000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.0000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.0000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.4000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.4000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.4000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.4000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 51163 AGUA BIDESTILADA 250 ML 0.0000 5.7900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 51163 AGUA BIDESTILADA 250 ML 0.0000 5.7900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 51164 AGUA BIDESTILADA 500 ML 0.0000 6.4300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.0000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 51379 SERINGA DESC 05 ML UN 0.0000 0.1900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 51434 BECLOMETASONA 400 MCG / ML 2 ML SL IN FL 0.0000 4.4800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 51434 BECLOMETASONA 400 MCG / ML 2 ML SL IN FL 0.0000 4.4800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 51434 BECLOMETASONA 400 MCG / ML 2 ML SL IN FL 0.0000 4.4800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 51434 BECLOMETASONA 400 MCG / ML 2 ML SL IN FL 0.0000 4.4800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 51434 BECLOMETASONA 400 MCG / ML 2 ML SL IN FL 0.0000 4.4800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 51622 MODULO DE PROTEINAS DO SORO DO LEITE PO EN GR 0.0000 6.6000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 51660 BROMETO DE IPRATROPIO SL IN GT 0.0000 1.2008 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 51660 BROMETO DE IPRATROPIO SL IN GT 0.0000 0.0000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 51710 CLORETO DE POTASSIO 15% 10 ML SI IV AP 0.0000 1.3700 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 52403 MORFINA 1 MG/ML 2 ML SI IM IT IV PE AP 0.0000 3.9900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00943 EQUIPO POLIFIX 2 VIAS UN 0.0000 5.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00992 ESPIRONOLACTONA 25 MG CP VO UN 0.0000 0.4800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00992 ESPIRONOLACTONA 25 MG CP VO UN 0.0000 0.4800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 01691 NISTATINA 100.000 UI/ML SU VO ML 0.0000 0.3000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 4e13adf421809cb755e1bdd80cc4efed AGRIPINA 12385409142 NULL 12385409142 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 4e13adf421809cb755e1bdd80cc4efed AGRIPINA 12385409142 NULL 12385409142 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 4e13adf421809cb755e1bdd80cc4efed AGRIPINA 12385409142 NULL 12385409142 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 4e13adf421809cb755e1bdd80cc4efed AGRIPINA 12385409142 NULL 12385409142 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.4000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 4e13adf421809cb755e1bdd80cc4efed AGRIPINA 12385409142 NULL 12385409142 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.4000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 75bcd473a0dc7c7a6751499b38a4a034 JOAQUIM 12692852143 NULL 12692852143 101001 DIARIA DE ENFERMARIA 0.0000 1733.2400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 75bcd473a0dc7c7a6751499b38a4a034 JOAQUIM 12692852143 NULL 12692852143 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4075 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 75bcd473a0dc7c7a6751499b38a4a034 JOAQUIM 12692852143 NULL 12692852143 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4075 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 75bcd473a0dc7c7a6751499b38a4a034 JOAQUIM 12692852143 NULL 12692852143 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 75bcd473a0dc7c7a6751499b38a4a034 JOAQUIM 12692852143 NULL 12692852143 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4075 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 75bcd473a0dc7c7a6751499b38a4a034 JOAQUIM 12692852143 NULL 12692852143 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4075 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 75bcd473a0dc7c7a6751499b38a4a034 JOAQUIM 12692852143 NULL 12692852143 01652 TRAMADOL 50 MG CP VO UN 0.0000 1.9272 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 75bcd473a0dc7c7a6751499b38a4a034 JOAQUIM 12692852143 NULL 12692852143 01652 TRAMADOL 50 MG CP VO UN 0.0000 1.9272 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 75bcd473a0dc7c7a6751499b38a4a034 JOAQUIM 12692852143 NULL 12692852143 00172 SORO FISIOLOGICO 0,9% 500 ML SI IV BS 0.0000 4.7300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 75bcd473a0dc7c7a6751499b38a4a034 JOAQUIM 12692852143 NULL 12692852143 00172 SORO FISIOLOGICO 0,9% 500 ML SI IV BS 0.0000 4.7300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 75bcd473a0dc7c7a6751499b38a4a034 JOAQUIM 12692852143 NULL 12692852143 21010099 Revisão de Lâmina 0.0000 0.0000 NULL COBRANCA DE HONORARIOS EM DUPLICIDADE 2607
Glosa Min 2018-10-03 00:00:00.000000 1084117 75bcd473a0dc7c7a6751499b38a4a034 JOAQUIM 12692852143 NULL 12692852143 34010068 Tomografia Comp. de Crânio 0.0000 0.0000 NULL EXAME SEM REGISTRO DE EXECUCAO 2703
Glosa Min 2018-10-03 00:00:00.000000 1084117 75bcd473a0dc7c7a6751499b38a4a034 JOAQUIM 12692852143 NULL 12692852143 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6850 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 75bcd473a0dc7c7a6751499b38a4a034 JOAQUIM 12692852143 NULL 12692852143 04073 TRAMADOL 50 MG 1 ML SI IM IV AP 0.0000 4.1900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 75bcd473a0dc7c7a6751499b38a4a034 JOAQUIM 12692852143 NULL 12692852143 04073 TRAMADOL 50 MG 1 ML SI IM IV AP 0.0000 4.1900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 75bcd473a0dc7c7a6751499b38a4a034 JOAQUIM 12692852143 NULL 12692852143 04073 TRAMADOL 50 MG 1 ML SI IM IV AP 0.0000 4.1900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00124 LUVA CIRURGICA UN 0.0000 1.4475 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00124 LUVA CIRURGICA UN 0.0000 1.4475 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00124 LUVA CIRURGICA UN 0.0000 1.4475 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00124 LUVA CIRURGICA UN 0.0000 1.4475 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 26981 SORO FISIOLOGICO 0,9% 10 ML SI IV AP 0.0000 0.4800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 26981 SORO FISIOLOGICO 0,9% 10 ML SI IV AP 0.0000 0.9600 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 26981 SORO FISIOLOGICO 0,9% 10 ML SI IV AP 0.0000 0.9600 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 03280 CLOREXIDINA 2 % ST TP ML 0.0000 0.5300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6875 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6875 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6875 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00487 RANITIDINA 25 MG/ML 2 ML SI IM IV AP 0.0000 0.9300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00487 RANITIDINA 25 MG/ML 2 ML SI IM IV AP 0.0000 0.9300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00487 RANITIDINA 25 MG/ML 2 ML SI IM IV AP 0.0000 0.9300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 51578 Frasco p/ alimentacao enteral 0.0000 2.4700 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 51584 ESPARADRAPO MICROPORE 0.0000 0.2560 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 51584 ESPARADRAPO MICROPORE 0.0000 0.2560 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 55795 FOSFATO DE POTASSIO 2 MEQ/ML 10 ML SI IV AP 0.0000 3.0200 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00069 SERINGA DESC 10 ML UN 0.0000 0.6700 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4088 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4088 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4088 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4088 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4088 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4088 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4088 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4088 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4088 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4088 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 02246 HIDROCORTISONA 100 MG PO IM IV FA 0.0000 2.8300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6872 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6872 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6872 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6872 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6872 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1766 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1766 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4070 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 22421 PIPERACILINA 2 G + TAZOBACTAM 250 MG 30 ML PO IV 0.0000 55.3400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 22421 PIPERACILINA 2 G + TAZOBACTAM 250 MG 30 ML PO IV 0.0000 55.3400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 25030019 Distúrbios Circulatórios Artério - Venosos e Linfáticos 0.0000 183.3600 NULL VALOR APRESENTADO A MAIOR 1705
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 35382 COMPRESSAS DE GASES 7.5 X7,5 (11 FIOS ESTERIL) UN 0.0000 0.3000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 000445 TAXA DE TRANSPORTE E INSTALACAO DE EQUIPAMENTO DE 0.0000 0.0000 NULL COBRANCA DE TAXAS, DE SERVICOS REALIZADOS EM AMBIENTES INCOMPATIVEIS COM O USO DE EQUIPAMENTOS 2407
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.4000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 51508 ENCRISE (ARGIPRESSINA) 20 U/ML 1 ML SI IM IV SC AP 0.0000 20.1200 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 51508 ENCRISE (ARGIPRESSINA) 20 U/ML 1 ML SI IM IV SC AP 0.0000 20.1200 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 51584 ESPARADRAPO MICROPORE 0.0000 0.2560 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 51584 ESPARADRAPO MICROPORE 0.0000 0.2560 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cd2840524be5a3f1d0939f241e24f32b MARIA 12705908340 NULL 12705908340 00181 SULFATO DE MAGNESIO 100 MG/ML 10 ML SI IM IV 0.0000 0.9467 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cd2840524be5a3f1d0939f241e24f32b MARIA 12705908340 NULL 12705908340 00184 CLORETO DE POTASSIO 10% 10 ML SI IV AP 0.0000 0.2967 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cd2840524be5a3f1d0939f241e24f32b MARIA 12705908340 NULL 12705908340 25030019 Distúrbios Circulatórios Artério - Venosos e Linfáticos 0.0000 0.0000 NULL EXAME SEM REGISTRO DE EXECUCAO 2703
Glosa Min 2018-10-03 00:00:00.000000 1084117 cd2840524be5a3f1d0939f241e24f32b MARIA 12705908340 NULL 12705908340 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cd2840524be5a3f1d0939f241e24f32b MARIA 12705908340 NULL 12705908340 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cd2840524be5a3f1d0939f241e24f32b MARIA 12705908340 NULL 12705908340 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 00090 SERINGA DESC 20 ML UN 0.0000 0.5379 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 00090 SERINGA DESC 20 ML UN 0.0000 0.5379 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 00090 SERINGA DESC 20 ML UN 0.0000 0.5379 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 01611 CLORETO DE POTASSIO 600 MG CA VO UN 0.0000 0.4867 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 01611 CLORETO DE POTASSIO 600 MG CA VO UN 0.0000 0.4867 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.8078 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 51208 SORO RINGER SIMPLES 500 ML SI IV BS 0.0000 5.9400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1773 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1773 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4094 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4094 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4094 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 01496 FENITOINA 50 MG/ML 5 ML SI IM IV AP 0.0000 2.3400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 25030019 Distúrbios Circulatórios Artério - Venosos e Linfáticos 0.0000 117.1821 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 26981 SORO FISIOLOGICO 0,9% 10 ML SI IV AP 0.0000 0.4800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 26981 SORO FISIOLOGICO 0,9% 10 ML SI IV AP 0.0000 0.4800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 26981 SORO FISIOLOGICO 0,9% 10 ML SI IV AP 0.0000 0.9600 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 26981 SORO FISIOLOGICO 0,9% 10 ML SI IV AP 0.0000 0.9600 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 26981 SORO FISIOLOGICO 0,9% 10 ML SI IV AP 0.0000 0.9600 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 26981 SORO FISIOLOGICO 0,9% 10 ML SI IV AP 0.0000 0.9600 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 26981 SORO FISIOLOGICO 0,9% 10 ML SI IV AP 0.0000 0.9600 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 26981 SORO FISIOLOGICO 0,9% 10 ML SI IV AP 0.0000 0.9600 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 26981 SORO FISIOLOGICO 0,9% 10 ML SI IV AP 0.0000 0.9600 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 03280 CLOREXIDINA 2 % ST TP ML 0.0000 0.5300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 52392 SONDA DE ASPIRAÇAO TRAQUEAL C/ VALVULA UN 0.0000 0.9400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 52392 SONDA DE ASPIRAÇAO TRAQUEAL C/ VALVULA UN 0.0000 0.9400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 09070 ACETILCISTEINA 600MG PO VO SA 0.0000 3.4950 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 00097 ABOCATH N 14 A 22 UN 0.0000 0.0000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 15f461c0ca379f375bd9f8b18fbb101a ANA 12753753845 NULL 12753753845 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.4000 NULL VALOR APRESENTADO A MAIOR 1705
Glosa Min 2018-10-03 00:00:00.000000 1084117 15f461c0ca379f375bd9f8b18fbb101a ANA 12753753845 NULL 12753753845 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.4000 NULL VALOR APRESENTADO A MAIOR 1705
Glosa Min 2018-10-03 00:00:00.000000 1084117 15f461c0ca379f375bd9f8b18fbb101a ANA 12753753845 NULL 12753753845 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1800 NULL VALOR APRESENTADO A MAIOR 1705
Glosa Min 2018-10-03 00:00:00.000000 1084117 15f461c0ca379f375bd9f8b18fbb101a ANA 12753753845 NULL 12753753845 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1800 NULL VALOR APRESENTADO A MAIOR 1705
Glosa Min 2018-10-03 00:00:00.000000 1084117 15f461c0ca379f375bd9f8b18fbb101a ANA 12753753845 NULL 12753753845 51241 AGULHA 123X45 0.0000 0.7700 NULL VALOR APRESENTADO A MAIOR 1705
Glosa Min 2018-10-03 00:00:00.000000 1084117 15f461c0ca379f375bd9f8b18fbb101a ANA 12753753845 NULL 12753753845 00657 CEFAZOLINA 1 GR + DIL. 10 ML PO IM IV FA 0.0000 8.1300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 11700 EQUIPO P/ BOMBA DE INFUSAO ENTERAL / PARENTERAL 0.0000 19.6942 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00124 LUVA CIRURGICA UN 0.0000 1.4500 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4056 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4072 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4072 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4072 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4072 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4072 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4072 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4072 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4072 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4072 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4072 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL COBRANCA DE MEDICAMENTO EM QUANTIDADE INCOMPATIVEL COM A PERMANENCIA 2107
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 01611 CLORETO DE POTASSIO 600 MG CA VO UN 0.0000 0.4870 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 02355 AMOXICILINA 1 G + CLAVULANATO 200 MG + DIL. 10 ML 0.0000 36.4667 NULL COBRANCA DE MEDICAMENTO EM QUANTIDADE INCOMPATIVEL COM A PERMANENCIA 2107
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 02355 AMOXICILINA 1 G + CLAVULANATO 200 MG + DIL. 10 ML 0.0000 36.4667 NULL COBRANCA DE MEDICAMENTO EM QUANTIDADE INCOMPATIVEL COM A PERMANENCIA 2107
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00090 SERINGA DESC 20 ML UN 0.0000 0.5367 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00090 SERINGA DESC 20 ML UN 0.0000 0.5367 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 2e6b6f291f2df9beb1fbda6028678909 ANNA 12463693448 NULL 12463693448 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 31d18d6607d9e742c53e748d6a55d740 CARLOS 12557779343 NULL 12557779343 54687 IODOPOVIDONA SD TP ML 0.0000 1.4200 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 31d18d6607d9e742c53e748d6a55d740 CARLOS 12557779343 NULL 12557779343 00657 CEFAZOLINA 1 GR + DIL. 10 ML PO IM IV FA 0.0000 8.1200 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 01002 FUROSEMIDA 10 MG/ML 2 ML SI IM IV AP 0.0000 1.8000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00111 ABOCATH N 14 A 22 UN 0.0000 3.7660 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00124 LUVA CIRURGICA UN 0.0000 1.4478 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00124 LUVA CIRURGICA UN 0.0000 1.4478 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00124 LUVA CIRURGICA UN 0.0000 1.4478 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00124 LUVA CIRURGICA UN 0.0000 1.4478 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00124 LUVA CIRURGICA UN 0.0000 1.4500 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6871 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6871 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6871 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6871 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 35382 COMPRESSAS DE GASES 7.5 X7,5 (11 FIOS ESTERIL) UN 0.0000 0.3000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 35382 COMPRESSAS DE GASES 7.5 X7,5 (11 FIOS ESTERIL) UN 0.0000 0.6000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.4000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.4000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.4000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.4000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.4000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.4000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1776 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 51649 ALCOOL ETILICO 70 % ST TP ML 0.0000 0.0000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 52303 NOREPINEFRINA 2 MG/ML 4 ML SI IV AP 0.0000 47.4800 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 54157 EQUIPO P/ DIETA ENTERAL UN 0.0000 1.7000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00090 SERINGA DESC 20 ML UN 0.0000 0.5375 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00090 SERINGA DESC 20 ML UN 0.0000 0.5375 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00090 SERINGA DESC 20 ML UN 0.0000 0.5375 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00090 SERINGA DESC 20 ML UN 0.0000 0.5400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.0000 NULL FALTA PRESCRICAO MEDICA 1709
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.8074 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.8074 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.8074 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.8074 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1775 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1775 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1775 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 51584 ESPARADRAPO MICROPORE 0.0000 0.3800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 51671 REPARIL (ESCINA + DIETILAMONIO) GL TP GR 0.0000 0.0000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 00090 SERINGA DESC 20 ML UN 0.0000 0.5375 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 00090 SERINGA DESC 20 ML UN 0.0000 0.5375 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 00090 SERINGA DESC 20 ML UN 0.0000 0.5375 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 00090 SERINGA DESC 20 ML UN 0.0000 0.5375 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 00090 SERINGA DESC 20 ML UN 0.0000 0.5375 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 00090 SERINGA DESC 20 ML UN 0.0000 0.5375 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd6f8d6c53ffe9bfd3aa9590ba500cc8 ILDA 12751932542 NULL 12751932542 00657 CEFAZOLINA 1 GR + DIL. 10 ML PO IM IV FA 0.0000 32.5000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd6f8d6c53ffe9bfd3aa9590ba500cc8 ILDA 12751932542 NULL 12751932542 00069 SERINGA DESC 10 ML UN 0.0000 0.6660 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 01691 NISTATINA 100.000 UI/ML SU VO ML 0.0000 0.3000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 20691 HIDROCORTISONA 100 MG PO IM IV FA 0.0000 2.8300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 20691 HIDROCORTISONA 100 MG PO IM IV FA 0.0000 2.8300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 20691 HIDROCORTISONA 100 MG PO IM IV FA 0.0000 2.8300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 20691 HIDROCORTISONA 100 MG PO IM IV FA 0.0000 2.8300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 20691 HIDROCORTISONA 100 MG PO IM IV FA 0.0000 2.8300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 20691 HIDROCORTISONA 100 MG PO IM IV FA 0.0000 2.8300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 26981 SORO FISIOLOGICO 0,9% 10 ML SI IV AP 0.0000 0.1400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 26981 SORO FISIOLOGICO 0,9% 10 ML SI IV AP 0.0000 0.1400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 26981 SORO FISIOLOGICO 0,9% 10 ML SI IV AP 0.0000 0.1400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 26981 SORO FISIOLOGICO 0,9% 10 ML SI IV AP 0.0000 0.1400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 26981 SORO FISIOLOGICO 0,9% 10 ML SI IV AP 0.0000 0.1400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 29020166 Nebulização Simples com Broncodilatador 0.0000 1.1700 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 29020166 Nebulização Simples com Broncodilatador 0.0000 8.0949 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1765 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1765 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1765 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1765 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1765 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 51241 AGULHA 123X45 0.0000 0.1900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 51241 AGULHA 123X45 0.0000 0.1900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 51241 AGULHA 123X45 0.0000 0.1900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 51241 AGULHA 123X45 0.0000 0.1900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 51659 FENOTEROL 2 MG/ML 10 ML AE IN DS 0.0000 0.2565 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 00090 SERINGA DESC 20 ML UN 0.0000 0.5373 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 00090 SERINGA DESC 20 ML UN 0.0000 0.5373 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 00097 ABOCATH N 14 A 22 UN 0.0000 3.7700 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 61e4786d45edfdbf19b77fb2c6ce6b9c REINALDO 12754482747 NULL 12754482747 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 61e4786d45edfdbf19b77fb2c6ce6b9c REINALDO 12754482747 NULL 12754482747 00172 SORO FISIOLOGICO 0,9% 500 ML SI IV BS 0.0000 4.7300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 61e4786d45edfdbf19b77fb2c6ce6b9c REINALDO 12754482747 NULL 12754482747 02178 TENOXICAM 20 MG + DIL. 2 ML PO IM IV FA 0.0000 7.1600 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 61e4786d45edfdbf19b77fb2c6ce6b9c REINALDO 12754482747 NULL 12754482747 30010128 Quimioterapia Sistêmica Inicial no 1o. Dia da Semana (por Ciclo de 7 Dias de Tratamento) 0.0000 0.0000 NULL COBRANCA DE HONORARIOS EM DUPLICIDADE 2607
Glosa Min 2018-10-03 00:00:00.000000 1084117 61e4786d45edfdbf19b77fb2c6ce6b9c REINALDO 12754482747 NULL 12754482747 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 61e4786d45edfdbf19b77fb2c6ce6b9c REINALDO 12754482747 NULL 12754482747 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 61e4786d45edfdbf19b77fb2c6ce6b9c REINALDO 12754482747 NULL 12754482747 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR APRESENTADO A MAIOR 1705
Glosa Min 2018-10-03 00:00:00.000000 1084117 61e4786d45edfdbf19b77fb2c6ce6b9c REINALDO 12754482747 NULL 12754482747 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 61e4786d45edfdbf19b77fb2c6ce6b9c REINALDO 12754482747 NULL 12754482747 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 61e4786d45edfdbf19b77fb2c6ce6b9c REINALDO 12754482747 NULL 12754482747 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 61e4786d45edfdbf19b77fb2c6ce6b9c REINALDO 12754482747 NULL 12754482747 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 61e4786d45edfdbf19b77fb2c6ce6b9c REINALDO 12754482747 NULL 12754482747 53780 VASELINA LIQUIDA SL OU TP ML 0.0000 0.0200 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 61e4786d45edfdbf19b77fb2c6ce6b9c REINALDO 12754482747 NULL 12754482747 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 61e4786d45edfdbf19b77fb2c6ce6b9c REINALDO 12754482747 NULL 12754482747 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 61e4786d45edfdbf19b77fb2c6ce6b9c REINALDO 12754482747 NULL 12754482747 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 61e4786d45edfdbf19b77fb2c6ce6b9c REINALDO 12754482747 NULL 12754482747 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4072 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4072 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4072 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4072 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4072 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 00090 SERINGA DESC 20 ML UN 0.0000 0.5400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 00091 SERINGA DESC 01 ML (INSULINA) UN 0.0000 0.3000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 081fdadb830fb547e83c43fabdb88372 ELZA 12377335349 NULL 12377335349 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 081fdadb830fb547e83c43fabdb88372 ELZA 12377335349 NULL 12377335349 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 081fdadb830fb547e83c43fabdb88372 ELZA 12377335349 NULL 12377335349 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 081fdadb830fb547e83c43fabdb88372 ELZA 12377335349 NULL 12377335349 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 081fdadb830fb547e83c43fabdb88372 ELZA 12377335349 NULL 12377335349 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 081fdadb830fb547e83c43fabdb88372 ELZA 12377335349 NULL 12377335349 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL EXAME SEM REGISTRO DE EXECUCAO 2703
Glosa Min 2018-10-03 00:00:00.000000 1084117 081fdadb830fb547e83c43fabdb88372 ELZA 12377335349 NULL 12377335349 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 081fdadb830fb547e83c43fabdb88372 ELZA 12377335349 NULL 12377335349 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 081fdadb830fb547e83c43fabdb88372 ELZA 12377335349 NULL 12377335349 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6860 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6860 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6860 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6860 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 51379 SERINGA DESC 05 ML UN 0.0000 0.1900 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 51379 SERINGA DESC 05 ML UN 0.0000 0.1900 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 51379 SERINGA DESC 05 ML UN 0.0000 0.1900 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 51379 SERINGA DESC 05 ML UN 0.0000 0.1900 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 51379 SERINGA DESC 05 ML UN 0.0000 0.1900 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 51379 SERINGA DESC 05 ML UN 0.0000 0.1900 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 345c226bfea274af1372d41b0305a6c8 ALTINO 12720257940 NULL 12720257940 00493 BROMOPRIDA 5 MG/ML 2 ML SI IM IV AP 0.0000 2.7300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 345c226bfea274af1372d41b0305a6c8 ALTINO 12720257940 NULL 12720257940 00090 SERINGA DESC 20 ML UN 0.0000 0.5364 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 345c226bfea274af1372d41b0305a6c8 ALTINO 12720257940 NULL 12720257940 00090 SERINGA DESC 20 ML UN 0.0000 0.5367 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 345c226bfea274af1372d41b0305a6c8 ALTINO 12720257940 NULL 12720257940 00090 SERINGA DESC 20 ML UN 0.0000 0.5400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 345c226bfea274af1372d41b0305a6c8 ALTINO 12720257940 NULL 12720257940 00090 SERINGA DESC 20 ML UN 0.0000 0.5367 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 345c226bfea274af1372d41b0305a6c8 ALTINO 12720257940 NULL 12720257940 00090 SERINGA DESC 20 ML UN 0.0000 0.5367 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 101001 DIARIA DE ENFERMARIA 0.0000 1386.5900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 01062 CATETER OXIGENIO TIPO OCULOS UN 0.0000 1.0000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 00124 LUVA CIRURGICA UN 0.0000 1.4500 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 00128 LUVA DE PROCEDIMENTO UNIDADE UN 0.0000 0.6700 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 00090 SERINGA DESC 20 ML UN 0.0000 0.5400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 00090 SERINGA DESC 20 ML UN 0.0000 0.5400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 00919 ALGODAO HIDROFILO BOLINHA UN 0.0000 0.2600 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 01652 TRAMADOL 50 MG CP VO UN 0.0000 1.9300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 01652 TRAMADOL 50 MG CP VO UN 0.0000 1.9300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6875 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 35382 COMPRESSAS DE GASES 7.5 X7,5 (11 FIOS ESTERIL) UN 0.0000 0.3000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 35382 COMPRESSAS DE GASES 7.5 X7,5 (11 FIOS ESTERIL) UN 0.0000 0.3000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.8100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3fb5c891f31bb9efcb05395066127c52 ALAIDE 12636273441 NULL 12636273441 00487 RANITIDINA 25 MG/ML 2 ML SI IM IV AP 0.0000 0.9300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3fb5c891f31bb9efcb05395066127c52 ALAIDE 12636273441 NULL 12636273441 00487 RANITIDINA 25 MG/ML 2 ML SI IM IV AP 0.0000 0.9300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 610c198ec4c064687cf0524f147d3aed ROBERTO 12748814743 NULL 12748814743 16322 BENZILPENICILINA POTASSICA CRIST. 5.000.000 8.0700 8.0683 0.0017 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 610c198ec4c064687cf0524f147d3aed ROBERTO 12748814743 NULL 12748814743 16322 BENZILPENICILINA POTASSICA CRIST. 5.000.000 8.0700 8.0683 0.0017 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 610c198ec4c064687cf0524f147d3aed ROBERTO 12748814743 NULL 12748814743 16322 BENZILPENICILINA POTASSICA CRIST. 5.000.000 8.0700 8.0683 0.0017 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.0800 0.1000 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 53932 ALPRAZOLAM 0,25 MG CP VO UN 0.2600 0.1100 0.1500 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00127 LUVA DE PROCEDIMENTO UNIDADE UN 0.3300 0.1300 0.2000 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00127 LUVA DE PROCEDIMENTO UNIDADE UN 0.3300 0.1300 0.2000 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00127 LUVA DE PROCEDIMENTO UNIDADE UN 0.3300 0.1300 0.2000 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.4000 0.1600 0.2400 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.4000 0.1600 0.2400 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.4000 0.1600 0.2400 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.4000 0.1600 0.2400 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.4000 0.1600 0.2400 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.4000 0.1600 0.2400 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.4000 0.1600 0.2400 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 51708 Dieta Hipercalorica Hiperproteica Sem Fibras 1.5 kcal 52.8500 20.6300 32.2200 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 54175 DIETA SEMI ELEMENTAR 1.0 KCAL/ML EM EN ML 57.6000 22.4900 35.1100 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 19400 CIPROFLOXACINO 2 MG/ML 100 ML SI IV BS 80.1700 31.3000 48.8700 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 19400 CIPROFLOXACINO 2 MG/ML 100 ML SI IV BS 80.1700 31.3000 48.8700 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 07802 PIPERACILINA 4 G + TAZOBACTAM 500 MG PO IV FA 83.4500 32.5900 50.8600 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 07802 PIPERACILINA 4 G + TAZOBACTAM 500 MG PO IV FA 83.4500 32.5900 50.8600 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 16b1e9f62f247f02ad5cac910ee15b4e BERCHOLINA 12631612848 NULL 12631612848 04073 TRAMADOL 50 MG 1 ML SI IM IV AP 4.1900 4.0000 0.1900 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 16b1e9f62f247f02ad5cac910ee15b4e BERCHOLINA 12631612848 NULL 12631612848 04073 TRAMADOL 50 MG 1 ML SI IM IV AP 4.1900 4.0000 0.1900 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 16b1e9f62f247f02ad5cac910ee15b4e BERCHOLINA 12631612848 NULL 12631612848 22421 PIPERACILINA 2 G + TAZOBACTAM 250 MG 30 ML PO IV 55.3400 52.7400 2.6000 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 16b1e9f62f247f02ad5cac910ee15b4e BERCHOLINA 12631612848 NULL 12631612848 22421 PIPERACILINA 2 G + TAZOBACTAM 250 MG 30 ML PO IV 55.3400 52.7400 2.6000 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 16b1e9f62f247f02ad5cac910ee15b4e BERCHOLINA 12631612848 NULL 12631612848 22421 PIPERACILINA 2 G + TAZOBACTAM 250 MG 30 ML PO IV 55.3400 52.7400 2.6000 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 16b1e9f62f247f02ad5cac910ee15b4e BERCHOLINA 12631612848 NULL 12631612848 22421 PIPERACILINA 2 G + TAZOBACTAM 250 MG 30 ML PO IV 55.3400 52.7400 2.6000 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 16b1e9f62f247f02ad5cac910ee15b4e BERCHOLINA 12631612848 NULL 12631612848 00171 SORO FISIOLOGICO 0,9% 250 ML SI IV BS 3.9400 3.7600 0.1800 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 16b1e9f62f247f02ad5cac910ee15b4e BERCHOLINA 12631612848 NULL 12631612848 00090 SERINGA DESC 20 ML UN 0.5400 0.5200 0.0200 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 16b1e9f62f247f02ad5cac910ee15b4e BERCHOLINA 12631612848 NULL 12631612848 00090 SERINGA DESC 20 ML UN 0.5400 0.5200 0.0200 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 16b1e9f62f247f02ad5cac910ee15b4e BERCHOLINA 12631612848 NULL 12631612848 00090 SERINGA DESC 20 ML UN 0.5400 0.5200 0.0200 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 16b1e9f62f247f02ad5cac910ee15b4e BERCHOLINA 12631612848 NULL 12631612848 00090 SERINGA DESC 20 ML UN 0.5400 0.5200 0.0200 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 16b1e9f62f247f02ad5cac910ee15b4e BERCHOLINA 12631612848 NULL 12631612848 36432 HIDROCLOROTIAZIDA 25 MG CP VO UN 0.2400 0.2300 0.0100 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 16b1e9f62f247f02ad5cac910ee15b4e BERCHOLINA 12631612848 NULL 12631612848 33219 LUVA DE PROCEDIMENTO UNIDADE UN 0.8370 1.0018 -0.3318 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 16b1e9f62f247f02ad5cac910ee15b4e BERCHOLINA 12631612848 NULL 12631612848 00590 AGULHA DESC 30 X 7 - 40X12 UN 4.3100 0.7126 3.5974 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 16b1e9f62f247f02ad5cac910ee15b4e BERCHOLINA 12631612848 NULL 12631612848 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4081 0.0019 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 16b1e9f62f247f02ad5cac910ee15b4e BERCHOLINA 12631612848 NULL 12631612848 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4081 0.0019 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 16b1e9f62f247f02ad5cac910ee15b4e BERCHOLINA 12631612848 NULL 12631612848 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4081 0.0019 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 16b1e9f62f247f02ad5cac910ee15b4e BERCHOLINA 12631612848 NULL 12631612848 33219 LUVA DE PROCEDIMENTO UNIDADE UN 1.0000 1.1688 -0.1688 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 32050054 RX Tórax: P. A. - Lat 20.2100 7.8900 12.3200 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 51673 ALGINATO DE CALCIO EM HIDROGEL GL TP GR 17.2500 6.7300 10.5200 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 32050038 RX Tórax: P. A. 15.7500 6.1500 9.6000 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00613 CLINDAMICINA 600 MG 4 ML SI IM IV AP 13.0800 5.1000 7.9800 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00613 CLINDAMICINA 600 MG 4 ML SI IM IV AP 13.0800 5.1000 7.9800 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00613 CLINDAMICINA 600 MG 4 ML SI IM IV AP 13.0800 5.1000 7.9800 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 51620 Modulo Em Pó De Fibras Solúveis 7.3100 2.8500 4.4600 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00404 LACTULOSE 667 MG/ML XP VO ML 6.4300 2.5100 3.9200 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 53144 TRAMAL 5.9900 2.3300 3.6600 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 53144 TRAMAL 5.9900 2.3300 3.6600 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00172 SORO FISIOLOGICO 0,9% 500 ML SI IV BS 4.7300 1.8400 2.8900 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 51673 ALGINATO DE CALCIO EM HIDROGEL GL TP GR 3.4500 1.3400 2.1100 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00493 BROMOPRIDA 5 MG/ML 2 ML SI IM IV AP 2.7300 1.0600 1.6700 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00493 BROMOPRIDA 5 MG/ML 2 ML SI IM IV AP 2.7300 1.0600 1.6700 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00493 BROMOPRIDA 5 MG/ML 2 ML SI IM IV AP 2.7300 1.0600 1.6700 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00128 LUVA DE PROCEDIMENTO UNIDADE UN 1.0000 0.3900 0.6100 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.6900 0.2700 0.4200 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.6900 0.2700 0.4200 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.6900 0.2700 0.4200 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.6900 0.2700 0.4200 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00090 SERINGA DESC 20 ML UN 0.5400 0.2200 0.3200 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00090 SERINGA DESC 20 ML UN 0.5400 0.2200 0.3200 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00090 SERINGA DESC 20 ML UN 0.5400 0.2200 0.3200 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00090 SERINGA DESC 20 ML UN 0.5400 0.2200 0.3200 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 3fb5c891f31bb9efcb05395066127c52 ALAIDE 12636273441 NULL 12636273441 14250 PARACETAMOL 750 MG CP VO UN 0.0000 0.0000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 f3ad474c8c562757c4d1a959ff0961c4 DJALMA 12718763240 NULL 12718763240 00090 SERINGA DESC 20 ML UN 0.0000 0.5400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 f3ad474c8c562757c4d1a959ff0961c4 DJALMA 12718763240 NULL 12718763240 00090 SERINGA DESC 20 ML UN 0.0000 0.5400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 f3ad474c8c562757c4d1a959ff0961c4 DJALMA 12718763240 NULL 12718763240 00090 SERINGA DESC 20 ML UN 0.0000 0.5400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 f3ad474c8c562757c4d1a959ff0961c4 DJALMA 12718763240 NULL 12718763240 51584 ESPARADRAPO MICROPORE 0.0000 0.7700 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 f3ad474c8c562757c4d1a959ff0961c4 DJALMA 12718763240 NULL 12718763240 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 f3ad474c8c562757c4d1a959ff0961c4 DJALMA 12718763240 NULL 12718763240 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 f3ad474c8c562757c4d1a959ff0961c4 DJALMA 12718763240 NULL 12718763240 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 f3ad474c8c562757c4d1a959ff0961c4 DJALMA 12718763240 NULL 12718763240 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 f3ad474c8c562757c4d1a959ff0961c4 DJALMA 12718763240 NULL 12718763240 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 f3ad474c8c562757c4d1a959ff0961c4 DJALMA 12718763240 NULL 12718763240 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 f3ad474c8c562757c4d1a959ff0961c4 DJALMA 12718763240 NULL 12718763240 102001 DIARIA DE APARTAMENTO 0.0000 288.8900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 00919 ALGODAO HIDROFILO BOLINHA UN 0.0000 0.2600 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 00090 SERINGA DESC 20 ML UN 0.0000 0.5400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 00090 SERINGA DESC 20 ML UN 0.0000 0.5400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 00090 SERINGA DESC 20 ML UN 0.0000 0.5400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 00090 SERINGA DESC 20 ML UN 0.0000 0.5400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 00090 SERINGA DESC 20 ML UN 0.0000 0.5400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 51649 ALCOOL ETILICO 70 % ST TP ML 0.0000 0.0300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4068 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 00128 LUVA DE PROCEDIMENTO UNIDADE UN 0.0000 1.0000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 00128 LUVA DE PROCEDIMENTO UNIDADE UN 0.0000 1.0000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 00128 LUVA DE PROCEDIMENTO UNIDADE UN 0.0000 0.6700 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 00128 LUVA DE PROCEDIMENTO UNIDADE UN 0.0000 0.6700 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 11325 EQUIPO MACRO-GOTAS FLEXIVEL C/ INJETOR LATERAL UN 0.0000 1.5900 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 102001 DIARIA DE APARTAMENTO 0.0000 288.8900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 102001 DIARIA DE APARTAMENTO 0.0000 288.8900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 102001 DIARIA DE APARTAMENTO 0.0000 288.8900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 06400 CARVEDILOL 3,125 MG CP VO UN 0.0000 0.7300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 54687 IODOPOVIDONA SD TP ML 0.0000 0.6000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 51588 ESPARADRAPO MICROPORE 50 X 10 CM CM 0.0000 0.7700 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 51588 ESPARADRAPO MICROPORE 50 X 10 CM CM 0.0000 0.7700 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 51497 ESPIRONOLACTONA 50 MG + HIDROCLOROTIAZIDA 50 MG 0.0000 0.9800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 51497 ESPIRONOLACTONA 50 MG + HIDROCLOROTIAZIDA 50 MG 0.0000 0.9800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 51497 ESPIRONOLACTONA 50 MG + HIDROCLOROTIAZIDA 50 MG 0.0000 0.9800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 51379 SERINGA DESC 05 ML UN 0.0000 0.1900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.8100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.8100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 00487 RANITIDINA 25 MG/ML 2 ML SI IM IV AP 0.0000 0.9300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 00487 RANITIDINA 25 MG/ML 2 ML SI IM IV AP 0.0000 0.9300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00817 ALGODAO HIDROFILO BOLINHA UN 0.2600 0.1300 0.1300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.4000 0.0000 0.4000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 00817 ALGODAO HIDROFILO BOLINHA UN 0.5100 0.2600 0.2500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 00485 AGUA BIDESTILADA 500 ML SI IM IV BS 6.4300 0.0000 6.4300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 28959 DERSANI LC TP ML 19.4000 14.5500 4.8500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.3500 0.0000 0.3500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 37761 ALCOOL ETILICO 70 % ST TP ML 0.0600 0.0300 0.0300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 00485 AGUA BIDESTILADA 500 ML SI IM IV BS 6.4300 0.0000 6.4300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 37761 ALCOOL ETILICO 70 % ST TP ML 0.0600 0.0300 0.0300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 00817 ALGODAO HIDROFILO BOLINHA UN 0.5100 0.2600 0.2500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 d17b3c5ae418d82694895a326dee545a ODILIA 12670516743 NULL 12670516743 37761 ALCOOL ETILICO 70 % ST TP ML 0.0300 0.0200 0.0100 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 d17b3c5ae418d82694895a326dee545a ODILIA 12670516743 NULL 12670516743 37761 ALCOOL ETILICO 70 % ST TP ML 0.0600 0.0200 0.0400 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 d17b3c5ae418d82694895a326dee545a ODILIA 12670516743 NULL 12670516743 37761 ALCOOL ETILICO 70 % ST TP ML 0.0600 0.0200 0.0400 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 d17b3c5ae418d82694895a326dee545a ODILIA 12670516743 NULL 12670516743 33219 LUVA DE PROCEDIMENTO UNIDADE UN 1.0000 0.6700 0.3300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 d17b3c5ae418d82694895a326dee545a ODILIA 12670516743 NULL 12670516743 37761 ALCOOL ETILICO 70 % ST TP ML 0.0300 0.0200 0.0100 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 d17b3c5ae418d82694895a326dee545a ODILIA 12670516743 NULL 12670516743 00817 ALGODAO HIDROFILO BOLINHA UN 0.2600 0.1300 0.1300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 37761 ALCOOL ETILICO 70 % ST TP ML 0.0300 0.0200 0.0100 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 00817 ALGODAO HIDROFILO BOLINHA UN 0.2600 0.1300 0.1300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 37761 ALCOOL ETILICO 70 % ST TP ML 0.0600 0.0300 0.0300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 37761 ALCOOL ETILICO 70 % ST TP ML 0.0600 0.0200 0.0400 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 11193 CLOREXIDINA 2 % ST TP ML 1.6000 0.2700 1.3300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 02720 BOLSA COLETORA (SISTEMA ABERTO) UN 1.2800 0.9600 0.3200 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 37761 ALCOOL ETILICO 70 % ST TP ML 0.0300 0.0200 0.0100 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00817 ALGODAO HIDROFILO BOLINHA UN 0.2600 0.1300 0.1300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 33219 LUVA DE PROCEDIMENTO UNIDADE UN 1.0000 0.6700 0.3300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 32891 EQUIPO POLIFIX 2ş VIAS UN 5.1000 0.0000 5.1000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00817 ALGODAO HIDROFILO BOLINHA UN 0.5100 0.2600 0.2500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00485 AGUA BIDESTILADA 500 ML SI IM IV BS 6.4300 0.0000 6.4300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00817 ALGODAO HIDROFILO BOLINHA UN 0.5100 0.2600 0.2500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 08648 ESPARADRAPO 10 X 4.5 CM CM 0.4000 0.0000 0.4000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00485 AGUA BIDESTILADA 500 ML SI IM IV BS 6.4300 0.0000 6.4300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 08648 ESPARADRAPO 10 X 4.5 CM CM 0.4000 0.2000 0.2000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 02720 BOLSA COLETORA (SISTEMA ABERTO) UN 1.2800 0.6400 0.6400 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 02720 BOLSA COLETORA (SISTEMA ABERTO) UN 1.2800 0.6400 0.6400 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.0000 0.1000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00485 AGUA BIDESTILADA 500 ML SI IM IV BS 6.4300 0.0000 6.4300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 37761 ALCOOL ETILICO 70 % ST TP ML 0.0600 0.0300 0.0300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.0000 0.1000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 37761 ALCOOL ETILICO 70 % ST TP ML 0.0600 0.0300 0.0300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00817 ALGODAO HIDROFILO BOLINHA UN 0.5100 0.2600 0.2500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 752c651cb4fd049e19c685f87fbe8bdc EDUARDO 12765990646 NULL 12765990646 37761 ALCOOL ETILICO 70 % ST TP ML 0.0300 0.0200 0.0100 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 752c651cb4fd049e19c685f87fbe8bdc EDUARDO 12765990646 NULL 12765990646 00817 ALGODAO HIDROFILO BOLINHA UN 0.2600 0.1300 0.1300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 752c651cb4fd049e19c685f87fbe8bdc EDUARDO 12765990646 NULL 12765990646 00817 ALGODAO HIDROFILO BOLINHA UN 0.2600 0.1300 0.1300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 752c651cb4fd049e19c685f87fbe8bdc EDUARDO 12765990646 NULL 12765990646 37761 ALCOOL ETILICO 70 % ST TP ML 0.0600 0.0200 0.0400 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 752c651cb4fd049e19c685f87fbe8bdc EDUARDO 12765990646 NULL 12765990646 37761 ALCOOL ETILICO 70 % ST TP ML 0.0300 0.0200 0.0100 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 08648 ESPARADRAPO 10 X 4.5 CM CM 0.4000 0.2000 0.2000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00817 ALGODAO HIDROFILO BOLINHA UN 0.2600 0.1300 0.1300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00817 ALGODAO HIDROFILO BOLINHA UN 0.2600 0.1300 0.1300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 02461 FENOTEROL 2 MG/ML 10 ML AE IN DS 2.5500 0.0000 2.5500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 05975 COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER 0.3000 0.0000 0.3000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 345c226bfea274af1372d41b0305a6c8 ALTINO 12720257940 NULL 12720257940 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1000 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 345c226bfea274af1372d41b0305a6c8 ALTINO 12720257940 NULL 12720257940 07269 DIPIRONA 500 MG/ML 2 ML SI IV IM AP 0.6900 0.6860 0.0040 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 345c226bfea274af1372d41b0305a6c8 ALTINO 12720257940 NULL 12720257940 07269 DIPIRONA 500 MG/ML 2 ML SI IV IM AP 0.6900 0.6860 0.0040 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 0405a686318e3fc262f105ed4be24d95 CARMELITA 12687161644 NULL 12687161644 08435 EQUIPO P/ BOMBA DE INFUSAO ENTERAL / PARENT 20.2800 20.2700 0.0000 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 0405a686318e3fc262f105ed4be24d95 CARMELITA 12687161644 NULL 12687161644 07269 DIPIRONA 500 MG/ML 2 ML SI IV IM AP 0.6900 0.6870 0.0030 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 ea6abb4182a48f0934f3e9eb5affa056 DILVA 12697455440 NULL 12697455440 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1750 0.0050 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 500e4b8f04552b423f9db8f81073659f FIDELIS 12763450340 NULL 12763450340 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1760 0.0040 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 500e4b8f04552b423f9db8f81073659f FIDELIS 12763450340 NULL 12763450340 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1760 0.0040 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 27600 ONDANSETRONA 2 MG/ML 4 ML SI IM IV AP 13.5300 0.0000 13.5300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1900 0.1850 0.0050 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 27600 ONDANSETRONA 2 MG/ML 4 ML SI IM IV AP 13.5300 0.0000 13.5300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 27600 ONDANSETRONA 2 MG/ML 4 ML SI IM IV AP 13.5300 0.0000 13.5300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 27600 ONDANSETRONA 2 MG/ML 4 ML SI IM IV AP 13.5300 0.0000 13.5300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 27600 ONDANSETRONA 2 MG/ML 4 ML SI IM IV AP 13.5300 0.0000 13.5300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 11193 CLOREXIDINA 2 % ST TP ML 0.5300 0.0000 0.5300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 27600 ONDANSETRONA 2 MG/ML 4 ML SI IM IV AP 13.5300 0.0000 13.5300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 08664 ESPARADRAPO MICROPORE 50 X 10 CM CM 0.2600 0.2562 0.0038 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 08664 ESPARADRAPO MICROPORE 50 X 10 CM CM 0.2600 0.2561 0.0039 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 00817 ALGODAO HIDROFILO BOLINHA UN 0.5100 0.2600 0.2500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 08648 ESPARADRAPO 10 X 4.5 CM CM 0.4000 0.0000 0.4000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 00817 ALGODAO HIDROFILO BOLINHA UN 0.5100 0.2600 0.2500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 02720 BOLSA COLETORA (SISTEMA ABERTO) UN 1.2800 0.9600 0.3200 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 37761 ALCOOL ETILICO 70 % ST TP ML 0.0600 0.0000 0.0600 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 32190 CLORETO DE POTASSIO 10% 10 ML SI IV AP 1.1900 0.0000 1.1900 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 00817 ALGODAO HIDROFILO BOLINHA UN 0.5100 0.2600 0.2500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 02720 BOLSA COLETORA (SISTEMA ABERTO) UN 1.2800 0.9600 0.3200 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 31d18d6607d9e742c53e748d6a55d740 CARLOS 12557779343 NULL 12557779343 11193 CLOREXIDINA 2 % ST TP ML 2.6600 1.8600 0.8000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 31d18d6607d9e742c53e748d6a55d740 CARLOS 12557779343 NULL 12557779343 27308 FIO MONOCRYL 5-0 C /AGULHA 1,65 45CM Y844G 44.2600 0.0000 44.2600 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 33219 LUVA DE PROCEDIMENTO UNIDADE UN 1.0000 0.6700 0.3300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3fb5c891f31bb9efcb05395066127c52 ALAIDE 12636273441 NULL 12636273441 33219 LUVA DE PROCEDIMENTO UNIDADE UN 1.6700 0.5000 1.1700 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 00817 ALGODAO HIDROFILO BOLINHA UN 0.2600 0.1300 0.1300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 37761 ALCOOL ETILICO 70 % ST TP ML 0.0300 0.0200 0.0100 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 00817 ALGODAO HIDROFILO BOLINHA UN 0.2600 0.1300 0.1300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 30376 BROMETO DE IPRATROPIO 0,25MG/ML SL IN GT 1.6000 0.0000 1.6000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 02461 FENOTEROL 2 MG/ML 10 ML AE IN DS 1.5300 0.0000 1.5300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 30376 BROMETO DE IPRATROPIO 0,25MG/ML SL IN GT 1.2000 0.0000 1.2000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 5f044434edae42d3d17c4392018c7824 DINORA 12673932742 NULL 12673932742 07269 DIPIRONA 500 MG/ML 2 ML SI IV IM AP 0.6900 0.0000 0.6900 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 5f044434edae42d3d17c4392018c7824 DINORA 12673932742 NULL 12673932742 19151 SERINGA DESC 10 ML UN 0.3300 0.0000 0.3300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 5f044434edae42d3d17c4392018c7824 DINORA 12673932742 NULL 12673932742 33219 LUVA DE PROCEDIMENTO UNIDADE UN 1.6700 0.0000 1.6700 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 d4089ccef13567fd45b16fb0b60685fa VERA 12656425943 NULL 12656425943 33219 LUVA DE PROCEDIMENTO UNIDADE UN 0.6700 0.0000 0.6700 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 11134 HEPARINA 5000 UI/ML 5 ML SI IV SC ML 14.4000 2.8800 11.5200 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 00817 ALGODAO HIDROFILO BOLINHA UN 0.5100 0.2600 0.2500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 20613 SORO GLICOSADO 5% 250 ML SI IV BS 10.1900 0.0000 10.1900 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 20206 SONDA RETAL Nş 20 UN 0.8300 0.0000 0.8300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cd2840524be5a3f1d0939f241e24f32b MARIA 12705908340 NULL 12705908340 37761 ALCOOL ETILICO 70 % ST TP ML 0.0300 0.0200 0.0100 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cd2840524be5a3f1d0939f241e24f32b MARIA 12705908340 NULL 12705908340 37761 ALCOOL ETILICO 70 % ST TP ML 0.0300 0.0200 0.0100 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cd2840524be5a3f1d0939f241e24f32b MARIA 12705908340 NULL 12705908340 00817 ALGODAO HIDROFILO BOLINHA UN 0.2600 0.1300 0.1300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cd2840524be5a3f1d0939f241e24f32b MARIA 12705908340 NULL 12705908340 32891 EQUIPO POLIFIX 2ş VIAS UN 5.1000 0.0000 5.1000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12603877940 NULL 12603877940 37761 ALCOOL ETILICO 70 % ST TP ML 0.0300 0.0200 0.0100 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12603877940 NULL 12603877940 55018 ALGINATO DE CALCIO EM HIDROGEL GL TP GR 20.7000 13.8000 6.9000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12603877940 NULL 12603877940 33219 LUVA DE PROCEDIMENTO UNIDADE UN 1.3300 0.6700 0.6600 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12603877940 NULL 12603877940 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 2.0200 0.8100 1.2100 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12603877940 NULL 12603877940 33219 LUVA DE PROCEDIMENTO UNIDADE UN 2.3300 0.6700 1.6600 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12603877940 NULL 12603877940 55018 ALGINATO DE CALCIO EM HIDROGEL GL TP GR 20.7000 13.8000 6.9000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12603877940 NULL 12603877940 11193 CLOREXIDINA 2 % ST TP ML 1.3300 0.2700 1.0600 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12603877940 NULL 12603877940 00817 ALGODAO HIDROFILO BOLINHA UN 0.2600 0.1300 0.1300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12603877940 NULL 12603877940 33227 LUVA CIRURGICA PAR UN 8.6900 5.7900 2.9000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12603877940 NULL 12603877940 00817 ALGODAO HIDROFILO BOLINHA UN 0.2600 0.1300 0.1300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12603877940 NULL 12603877940 00540 AGULHA DESC 13 X 45 UN 0.7700 0.5800 0.1900 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12603877940 NULL 12603877940 37761 ALCOOL ETILICO 70 % ST TP ML 0.0300 0.0200 0.0100 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12603877940 NULL 12603877940 33219 LUVA DE PROCEDIMENTO UNIDADE UN 3.0000 0.6700 2.3300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 37761 ALCOOL ETILICO 70 % ST TP ML 0.0300 0.0200 0.0100 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 37761 ALCOOL ETILICO 70 % ST TP ML 0.0300 0.0200 0.0100 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 02461 FENOTEROL 2 MG/ML 10 ML AE IN DS 1.7900 0.0000 1.7900 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 5f044434edae42d3d17c4392018c7824 DINORA 12673932742 NULL 12673932742 101002 MEIA DIARIA DE ENFERMARIA 0.0000 0.0000 NULL ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 4ff3856efb5e71b547222c677fd1e9f1 DIVINO 12652092848 NULL 12652092848 29020166 NEBULIZACAO SIMPLES COM BRONCODILAT 0.0000 1.1700 NULL ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 4ff3856efb5e71b547222c677fd1e9f1 DIVINO 12652092848 NULL 12652092848 25040014 ASSISTENCIA FISIATRICA RESPIRATORIA 0.0000 5.0300 NULL ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 818a6f2e549cc6a60aa20f9d0595eec9 ANTONIO 12565134343 NULL 12565134343 19160 SERINGA DESC 20 ML UN 0.5400 0.5371 0.0029 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 a050ed50115d2a6dd0b15b99b39063da ARI 12676101147 NULL 12676101147 20672 SORO RINGER SIMPLES 500 ML SI IV BS 5.9400 5.9300 0.0000 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 a050ed50115d2a6dd0b15b99b39063da ARI 12676101147 NULL 12676101147 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8000 0.0000 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 a050ed50115d2a6dd0b15b99b39063da ARI 12676101147 NULL 12676101147 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1750 0.0050 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 a050ed50115d2a6dd0b15b99b39063da ARI 12676101147 NULL 12676101147 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1750 0.0050 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 a050ed50115d2a6dd0b15b99b39063da ARI 12676101147 NULL 12676101147 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1750 0.0050 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 a050ed50115d2a6dd0b15b99b39063da ARI 12676101147 NULL 12676101147 13404 OMEPRAZOL 40 MG + DIL. 10 ML PO IV FA 19.5800 19.5750 0.0050 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 a050ed50115d2a6dd0b15b99b39063da ARI 12676101147 NULL 12676101147 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4067 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 edffb7fef608512400078fdf75991573 CARLA 12728631049 NULL 12728631049 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4000 0.0000 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 39df67956a358bf1eab89803158d25dd HELENA 12655863342 NULL 12655863342 27480 CLARITROMICINA 500 MG 30 ML PO IV FA 117.1100 117.1050 0.0050 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 39df67956a358bf1eab89803158d25dd HELENA 12655863342 NULL 12655863342 27480 CLARITROMICINA 500 MG 30 ML PO IV FA 117.1100 117.1050 0.0050 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 cb57fc8e673b7c8bc339e1fe25d70cd5 HELIO 12661165148 NULL 12661165148 07269 DIPIRONA 500 MG/ML 2 ML SI IV IM AP 0.6900 0.6866 0.0034 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 a795ed48a125f20b79858b662b4e4e97 JOACIL 12711488840 NULL 12711488840 07269 DIPIRONA 500 MG/ML 2 ML SI IV IM AP 0.6900 0.6800 0.0000 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 4668d2494ed6c4b2d18be299efcb26a2 JOAO 12469689344 NULL 12469689344 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 6.8200 6.8100 0.0000 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 4668d2494ed6c4b2d18be299efcb26a2 JOAO 12469689344 NULL 12469689344 17817 PROLOPA (LEVODOPA 200 MG + BENSERAZIDA 50 M 2.1200 2.1150 0.0050 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 49824 NISTATINA 100.000 UI SU VO ML 0.3000 0.2950 0.0050 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 01081195 6cc865b10b9b19e72ae4fa1d739f24ec LAURITA 12743093016 NULL 12743093016 00010014 CONSULTA EM CONSULTORIO MEDICO 0.0000 35.0000 NULL ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 29020166 NEBULIZACAO SIMPLES COM BRONCODILAT 0.0000 1.1700 NULL ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 db30f3ff84b452c3d28d4f388c6e9976 SIRLEY 12660334845 NULL 12660334845 25040014 ASSISTENCIA FISIATRICA RESPIRATORIA 0.0000 60.3400 NULL ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 6799aa3de305405ab065aad5b599765c VANIR 12700232345 NULL 12700232345 29020166 NEBULIZACAO SIMPLES COM BRONCODILAT 0.0000 12.8800 NULL ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 de1a8276d878171456d7fc8f6dcd2457 ABEL 12764206443 NULL 12764206443 07269 DIPIRONA 500 MG/ML 2 ML SI IV IM AP 0.6900 0.6860 0.0040 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 de1a8276d878171456d7fc8f6dcd2457 ABEL 12764206443 NULL 12764206443 07269 DIPIRONA 500 MG/ML 2 ML SI IV IM AP 0.6900 0.6860 0.0040 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1770 0.0030 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1770 0.0030 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1770 0.0030 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1770 0.0030 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1770 0.0030 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1770 0.0030 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1770 0.0030 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1770 0.0030 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1770 0.0030 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8072 0.0028 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8072 0.0028 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8072 0.0028 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8072 0.0028 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8072 0.0028 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 09733 ACETILCISTEINA 600MG PO VO SA 3.5000 3.4955 0.0045 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 09733 ACETILCISTEINA 600MG PO VO SA 3.5000 3.4955 0.0045 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 09733 ACETILCISTEINA 600MG PO VO SA 3.5000 3.4955 0.0045 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 09733 ACETILCISTEINA 600MG PO VO SA 3.5000 3.4955 0.0045 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 09733 ACETILCISTEINA 600MG PO VO SA 3.5000 3.4955 0.0045 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 09733 ACETILCISTEINA 600MG PO VO SA 3.5000 3.4955 0.0045 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 09733 ACETILCISTEINA 600MG PO VO SA 3.5000 3.4955 0.0045 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 08664 ESPARADRAPO MICROPORE 50 X 10 CM CM 0.2600 0.2561 0.0039 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 08664 ESPARADRAPO MICROPORE 50 X 10 CM CM 0.7700 0.7682 0.0018 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 08664 ESPARADRAPO MICROPORE 50 X 10 CM CM 0.7700 0.7682 0.0018 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 08664 ESPARADRAPO MICROPORE 50 X 10 CM CM 0.7700 0.7682 0.0018 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 37761 ALCOOL ETILICO 70 % ST TP ML 0.0200 0.0150 0.0050 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 20672 SORO RINGER SIMPLES 500 ML SI IV BS 5.9400 5.9367 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 22896 CEFUROXIMA 750 MG + DIL. 6 ML PO IM IV FA 26.1300 26.1271 0.0029 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 22896 CEFUROXIMA 750 MG + DIL. 6 ML PO IM IV FA 26.1300 26.1271 0.0029 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4078 0.0022 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4078 0.0022 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4078 0.0022 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4078 0.0022 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4078 0.0022 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4078 0.0022 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4078 0.0022 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 33227 LUVA CIRURGICA PAR UN 1.4500 1.4476 0.0024 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 33227 LUVA CIRURGICA PAR UN 1.4500 1.4476 0.0024 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 33227 LUVA CIRURGICA PAR UN 1.4500 1.4476 0.0024 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1038 -0.0038 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1038 -0.0038 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 b288bbcfb9aecab51bcb0dba62ca0059 IVONETE 12743730847 NULL 12743730847 19160 SERINGA DESC 20 ML UN 0.5400 0.5367 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 b288bbcfb9aecab51bcb0dba62ca0059 IVONETE 12743730847 NULL 12743730847 19160 SERINGA DESC 20 ML UN 0.5400 0.5367 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 b288bbcfb9aecab51bcb0dba62ca0059 IVONETE 12743730847 NULL 12743730847 19160 SERINGA DESC 20 ML UN 0.5400 0.5367 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1900 0.1900 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1900 0.1900 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 11193 CLOREXIDINA 2 % ST TP ML 0.5300 0.5300 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 33227 LUVA CIRURGICA PAR UN 1.4500 0.0000 1.4500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 32891 EQUIPO POLIFIX 2ş VIAS UN 2.5500 0.0000 2.5500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4084 0.0016 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4084 0.0016 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4084 0.0016 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4084 0.0016 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4084 0.0016 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4084 0.0016 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4084 0.0016 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4084 0.0016 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4084 0.0016 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 2a79bf9d53875b480086bd7b8321c4f1 JOSE 12641066643 NULL 12641066643 42358 FUROSEMIDA 10 MG/ML 2 ML SI IM IV AP 1.2000 1.1900 0.0000 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 2a79bf9d53875b480086bd7b8321c4f1 JOSE 12641066643 NULL 12641066643 12262 ISOSSORBIDA 20 MG CP VO UN 0.2200 0.2167 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 00817 ALGODAO HIDROFILO BOLINHA UN 0.1300 0.0000 0.1300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 05975 COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER 0.3000 0.0000 0.3000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 32204 CLORETO DE SODIO 0,9% 10 ML SI IV AP 0.4800 0.0000 0.4800 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 32204 CLORETO DE SODIO 0,9% 10 ML SI IV AP 0.4800 0.4800 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 32204 CLORETO DE SODIO 0,9% 10 ML SI IV AP 0.4800 0.4800 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 32204 CLORETO DE SODIO 0,9% 10 ML SI IV AP 0.4800 0.0000 0.4800 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 32204 CLORETO DE SODIO 0,9% 10 ML SI IV AP 0.4800 0.0000 0.4800 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8067 0.0033 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8067 0.0033 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8067 0.0033 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8067 0.0033 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8067 0.0033 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8067 0.0033 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 32204 CLORETO DE SODIO 0,9% 10 ML SI IV AP 0.4800 0.0000 0.4800 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 32204 CLORETO DE SODIO 0,9% 10 ML SI IV AP 0.4800 0.0000 0.4800 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 32204 CLORETO DE SODIO 0,9% 10 ML SI IV AP 0.9600 0.9600 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 32204 CLORETO DE SODIO 0,9% 10 ML SI IV AP 0.4800 0.0000 0.4800 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.0000 0.8100 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8080 0.0020 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 32204 CLORETO DE SODIO 0,9% 10 ML SI IV AP 0.9600 0.0000 0.9600 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 32204 CLORETO DE SODIO 0,9% 10 ML SI IV AP 0.9600 0.0000 0.9600 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 30376 BROMETO DE IPRATROPIO 0,25MG/ML SL IN GT 0.8000 0.0000 0.8000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 14460 DOMPERIDONA 10 MG CP VO UN 0.3900 0.0000 0.3900 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 32204 CLORETO DE SODIO 0,9% 10 ML SI IV AP 0.4800 0.0000 0.4800 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e715e2ae28a6229c8609756d3298bf52 MARIA 12734221144 NULL 12734221144 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1750 0.0050 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 05975 COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER 0.3000 0.0000 0.3000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 11193 CLOREXIDINA 2 % ST TP ML 0.5300 0.5300 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 11193 CLOREXIDINA 2 % ST TP ML 0.5300 0.5300 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 05975 COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER 0.3000 0.3837 -0.0837 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 05975 COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER 0.3000 0.0000 0.3000 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 19119 SERINGA DESC 01 ML (INSULINA) UN 0.3100 0.3050 0.0050 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 33537 PIPERACILINA 2 G + TAZOBACTAM 250 MG 30 ML 55.3400 55.3375 0.0025 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 33537 PIPERACILINA 2 G + TAZOBACTAM 250 MG 30 ML 55.3400 55.3375 0.0025 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 33537 PIPERACILINA 2 G + TAZOBACTAM 250 MG 30 ML 55.3400 55.3375 0.0025 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 33537 PIPERACILINA 2 G + TAZOBACTAM 250 MG 30 ML 55.3400 55.3375 0.0025 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 42358 FUROSEMIDA 10 MG/ML 2 ML SI IM IV AP 1.2000 1.1964 0.0036 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 42358 FUROSEMIDA 10 MG/ML 2 ML SI IM IV AP 1.2000 1.1964 0.0036 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4061 0.0039 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4061 0.0039 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4061 0.0039 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4061 0.0039 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4061 0.0039 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 33227 LUVA CIRURGICA PAR UN 1.4500 1.4477 0.0023 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 33227 LUVA CIRURGICA PAR UN 1.4500 1.4477 0.0023 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 33227 LUVA CIRURGICA PAR UN 1.4500 1.4477 0.0023 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 33227 LUVA CIRURGICA PAR UN 1.4500 1.4477 0.0023 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 33227 LUVA CIRURGICA PAR UN 1.4500 1.4477 0.0023 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 33227 LUVA CIRURGICA PAR UN 1.4500 1.4477 0.0023 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 37761 ALCOOL ETILICO 70 % ST TP ML 0.0300 0.0000 0.0300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 37761 ALCOOL ETILICO 70 % ST TP ML 0.0300 0.0200 0.0100 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 22748 LIDOCAINA 2% GE TP OU GR 0.2600 0.0000 0.2600 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00817 ALGODAO HIDROFILO BOLINHA UN 0.1300 0.0000 0.1300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 19135 SERINGA DESC 03 ML UN 0.1500 0.0000 0.1500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.2100 0.2057 0.0043 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1772 0.0028 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1772 0.0028 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1772 0.0028 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1772 0.0028 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1772 0.0028 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1772 0.0028 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1772 0.0028 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 08664 ESPARADRAPO MICROPORE 50 X 10 CM CM 0.7700 0.7670 0.0030 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cd2840524be5a3f1d0939f241e24f32b MARIA 12705908340 NULL 12705908340 32204 CLORETO DE SODIO 0,9% 10 ML SI IV AP 0.4800 0.0000 0.4800 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cd2840524be5a3f1d0939f241e24f32b MARIA 12705908340 NULL 12705908340 32204 CLORETO DE SODIO 0,9% 10 ML SI IV AP 0.4800 0.4800 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cd2840524be5a3f1d0939f241e24f32b MARIA 12705908340 NULL 12705908340 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1764 0.0036 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cd2840524be5a3f1d0939f241e24f32b MARIA 12705908340 NULL 12705908340 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1764 0.0036 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 d17b3c5ae418d82694895a326dee545a ODILIA 12670516743 NULL 12670516743 30376 BROMETO DE IPRATROPIO 0,25MG/ML SL IN GT 0.4000 0.0000 0.4000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 d17b3c5ae418d82694895a326dee545a ODILIA 12670516743 NULL 12670516743 30376 BROMETO DE IPRATROPIO 0,25MG/ML SL IN GT 0.4000 0.0000 0.4000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 d17b3c5ae418d82694895a326dee545a ODILIA 12670516743 NULL 12670516743 30376 BROMETO DE IPRATROPIO 0,25MG/ML SL IN GT 0.4000 0.0000 0.4000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 d17b3c5ae418d82694895a326dee545a ODILIA 12670516743 NULL 12670516743 32204 CLORETO DE SODIO 0,9% 10 ML SI IV AP 0.4800 0.0000 0.4800 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 d17b3c5ae418d82694895a326dee545a ODILIA 12670516743 NULL 12670516743 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1774 0.0026 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 d17b3c5ae418d82694895a326dee545a ODILIA 12670516743 NULL 12670516743 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1774 0.0026 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1766 0.0034 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1766 0.0034 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 8a5ecfde671848d05ac757e0112e689c TEREZINHA 12700337042 NULL 12700337042 09733 ACETILCISTEINA 600MG PO VO SA 3.5000 3.4967 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 8a5ecfde671848d05ac757e0112e689c TEREZINHA 12700337042 NULL 12700337042 09733 ACETILCISTEINA 600MG PO VO SA 3.5000 3.4967 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 8a5ecfde671848d05ac757e0112e689c TEREZINHA 12700337042 NULL 12700337042 57258 FUMARATO DE QUETIAPINA 25 MG CA VO UN 1.2500 1.2450 0.0050 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 8a5ecfde671848d05ac757e0112e689c TEREZINHA 12700337042 NULL 12700337042 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4071 0.0029 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 8a5ecfde671848d05ac757e0112e689c TEREZINHA 12700337042 NULL 12700337042 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4071 0.0029 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 8a5ecfde671848d05ac757e0112e689c TEREZINHA 12700337042 NULL 12700337042 19160 SERINGA DESC 20 ML UN 0.5400 0.5368 0.0032 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 8a5ecfde671848d05ac757e0112e689c TEREZINHA 12700337042 NULL 12700337042 19160 SERINGA DESC 20 ML UN 0.5400 0.5376 0.0024 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 8a5ecfde671848d05ac757e0112e689c TEREZINHA 12700337042 NULL 12700337042 19160 SERINGA DESC 20 ML UN 0.5400 0.5376 0.0024 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 8a5ecfde671848d05ac757e0112e689c TEREZINHA 12700337042 NULL 12700337042 19160 SERINGA DESC 20 ML UN 0.5400 0.5376 0.0024 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 70cf23c63f890f0b61da2542c3e13a09 TIAGO 12741864645 NULL 12741864645 10634 GLICOSE 50% 20 ML SI IV AP 2.1400 2.1300 0.0000 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 70cf23c63f890f0b61da2542c3e13a09 TIAGO 12741864645 NULL 12741864645 32719 CEFAZOLINA 1 GR + DIL. 10 ML FA 16.2600 16.2500 0.0000 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 70cf23c63f890f0b61da2542c3e13a09 TIAGO 12741864645 NULL 12741864645 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1762 0.0038 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 70cf23c63f890f0b61da2542c3e13a09 TIAGO 12741864645 NULL 12741864645 19160 SERINGA DESC 20 ML UN 0.5400 0.5364 0.0036 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 70cf23c63f890f0b61da2542c3e13a09 TIAGO 12741864645 NULL 12741864645 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4075 0.0025 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 32204 CLORETO DE SODIO 0,9% 10 ML SI IV AP 0.9600 0.9600 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4070 0.0030 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 0111beed375944f60c7ad4a7fd4874f8 WALDIR 12746025744 NULL 12746025744 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 1.6200 1.6147 0.0053 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 0111beed375944f60c7ad4a7fd4874f8 WALDIR 12746025744 NULL 12746025744 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4076 0.0024 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 0111beed375944f60c7ad4a7fd4874f8 WALDIR 12746025744 NULL 12746025744 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4076 0.0024 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 0111beed375944f60c7ad4a7fd4874f8 WALDIR 12746025744 NULL 12746025744 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4076 0.0024 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 0111beed375944f60c7ad4a7fd4874f8 WALDIR 12746025744 NULL 12746025744 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4076 0.0024 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 0111beed375944f60c7ad4a7fd4874f8 WALDIR 12746025744 NULL 12746025744 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4076 0.0024 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 0111beed375944f60c7ad4a7fd4874f8 WALDIR 12746025744 NULL 12746025744 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4076 0.0024 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 0111beed375944f60c7ad4a7fd4874f8 WALDIR 12746025744 NULL 12746025744 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4076 0.0024 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 0111beed375944f60c7ad4a7fd4874f8 WALDIR 12746025744 NULL 12746025744 19160 SERINGA DESC 20 ML UN 0.5400 0.5379 0.0021 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 0111beed375944f60c7ad4a7fd4874f8 WALDIR 12746025744 NULL 12746025744 19160 SERINGA DESC 20 ML UN 0.5400 0.5379 0.0021 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 0111beed375944f60c7ad4a7fd4874f8 WALDIR 12746025744 NULL 12746025744 19160 SERINGA DESC 20 ML UN 0.5400 0.5379 0.0021 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 0111beed375944f60c7ad4a7fd4874f8 WALDIR 12746025744 NULL 12746025744 19160 SERINGA DESC 20 ML UN 0.5400 0.5379 0.0021 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 00817 ALGODAO HIDROFILO BOLINHA UN 0.1300 0.0000 0.1300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 00817 ALGODAO HIDROFILO BOLINHA UN 0.2600 0.0000 0.2600 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 52353 ABAIXADOR DE LINGUA UN 0.0500 0.0267 0.0233 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 00817 ALGODAO HIDROFILO BOLINHA UN 0.2600 0.0000 0.2600 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 00817 ALGODAO HIDROFILO BOLINHA UN 0.2600 0.0000 0.2600 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 00817 ALGODAO HIDROFILO BOLINHA UN 0.5100 0.0000 0.5100 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 37761 ALCOOL ETILICO 70 % ST TP ML 0.0600 0.0000 0.0600 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 27596 TIRA TESTE PARA GLICOSE UN 1.0400 1.0400 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 27596 TIRA TESTE PARA GLICOSE UN 1.0400 1.0400 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 27596 TIRA TESTE PARA GLICOSE UN 1.0400 1.0400 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 05975 COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER 0.3000 0.0000 0.3000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 05975 COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER 0.3000 0.0000 0.3000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 05975 COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER 0.6000 0.0000 0.6000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12662414945 NULL 12662414945 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1750 0.0050 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12662414945 NULL 12662414945 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4071 0.0029 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 05975 COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER 0.3000 0.1500 0.1500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 33227 LUVA CIRURGICA PAR UN 1.4500 1.4476 0.0024 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 33227 LUVA CIRURGICA PAR UN 1.4500 1.4476 0.0024 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1770 0.0030 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1770 0.0030 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1770 0.0030 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1770 0.0030 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN NULL 0.0000 NULL OPME INVALIDO 2201
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 34789 SONDA ASPIRAÇAO C/ VALVULA - TODAS - UTI UN 0.9400 0.9365 0.0035 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 25798 LOSARTANA 50 MG CP VO UN 1.3300 0.0000 1.3300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 19151 SERINGA DESC 10 ML UN 0.3300 0.0000 0.3300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.0000 0.1000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.2120 -0.1120 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.2120 -0.1120 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1060 -0.0060 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1060 -0.0060 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1060 -0.0060 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1060 -0.0060 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1060 -0.0060 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1060 -0.0060 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1060 -0.0060 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1060 -0.0060 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 34827 TIORFAN (RACECADOTRILA) 100 MG CA VO UN 3.2000 6.4000 -3.2000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 34827 TIORFAN (RACECADOTRILA) 100 MG CA VO UN 3.2000 3.2000 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 27596 TIRA TESTE PARA GLICOSE UN 1.0400 2.0800 -1.0400 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 27596 TIRA TESTE PARA GLICOSE UN 1.0400 1.0400 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 19160 SERINGA DESC 20 ML UN 0.5400 0.5374 0.0026 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 19160 SERINGA DESC 20 ML UN 0.5400 0.5374 0.0026 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 19160 SERINGA DESC 20 ML UN 0.5400 0.5374 0.0026 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 31585 RANITIDINA 25 MG/ML 2 ML SI IV IM AP 0.9300 1.8668 -0.9368 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 31585 RANITIDINA 25 MG/ML 2 ML SI IV IM AP 0.9300 0.9334 -0.0034 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 31585 RANITIDINA 25 MG/ML 2 ML SI IV IM AP 0.9300 0.9334 -0.0034 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 31585 RANITIDINA 25 MG/ML 2 ML SI IV IM AP 0.9300 0.9334 -0.0034 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 19151 SERINGA DESC 10 ML UN 0.6634 1.0003 -0.6703 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 19151 SERINGA DESC 10 ML UN 0.3300 0.6669 -0.3369 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 19151 SERINGA DESC 10 ML UN 0.3300 0.6669 -0.3369 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 19151 SERINGA DESC 10 ML UN 0.3300 0.6669 -0.3369 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 19151 SERINGA DESC 10 ML UN 0.3300 0.6669 -0.3369 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 19151 SERINGA DESC 10 ML UN 0.3300 0.6669 -0.3369 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 19151 SERINGA DESC 10 ML UN 0.3300 0.6669 -0.3369 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 19151 SERINGA DESC 10 ML UN 0.3300 0.6669 -0.3369 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 19151 SERINGA DESC 10 ML UN 0.3300 0.6669 -0.3369 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 19151 SERINGA DESC 10 ML UN 0.3300 0.6669 -0.3369 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 13935 METAMUCIL (PLANTAGO OVATA) 5,85 G PO VO E 4.9236 7.3907 -4.9307 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 07269 DIPIRONA 500 MG/ML 2 ML SI IV IM AP 0.6900 0.6860 0.0040 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 37761 ALCOOL ETILICO 70 % ST TP ML 0.0631 0.0695 -0.0395 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 37761 ALCOOL ETILICO 70 % ST TP ML 0.0598 0.0662 -0.0362 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 21822 TRAMADOL 50 MG 1 ML SI IM IV AP 25.1571 29.3540 -25.1640 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 11193 CLOREXIDINA 2 % ST TP ML 0.5300 0.5320 -0.0020 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 11193 CLOREXIDINA 2 % ST TP ML 0.5300 0.5320 -0.0020 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 800720d33fe0defb6121e82dd216d044 JALMO 12786952647 NULL 12786952647 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 800720d33fe0defb6121e82dd216d044 JALMO 12786952647 NULL 12786952647 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 800720d33fe0defb6121e82dd216d044 JALMO 12786952647 NULL 12786952647 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 11700 EQUIPO P/ BOMBA DE INFUSAO ENTERAL / PARENTERAL 0.0000 20.2800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4075 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00172 SORO FISIOLOGICO 0,9% 500 ML SI IV BS 0.0000 4.7300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00172 SORO FISIOLOGICO 0,9% 500 ML SI IV BS 0.0000 4.7300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 02246 HIDROCORTISONA 100 MG PO IM IV FA 0.0000 2.8300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 02246 HIDROCORTISONA 100 MG PO IM IV FA 0.0000 5.6700 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 02246 HIDROCORTISONA 100 MG PO IM IV FA 0.0000 5.6700 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 26981 SORO FISIOLOGICO 0,9% 10 ML SI IV AP 0.0000 0.0000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 26981 SORO FISIOLOGICO 0,9% 10 ML SI IV AP 0.0000 0.0000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00613 CLINDAMICINA 600 MG 4 ML SI IM IV AP 0.0000 13.0800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00613 CLINDAMICINA 600 MG 4 ML SI IM IV AP 0.0000 13.0800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00735 CEFTRIAXONA IV 1G + DIL. 10 ML PO IV FA 0.0000 54.1300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 07802 PIPERACILINA 4 G + TAZOBACTAM 500 MG PO IV FA 0.0000 83.4500 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 07802 PIPERACILINA 4 G + TAZOBACTAM 500 MG PO IV FA 0.0000 0.0000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 09071 ACETILCISTEINA 600MG PO VO SA 0.0000 3.4950 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 09071 ACETILCISTEINA 600MG PO VO SA 0.0000 3.4950 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00091 SERINGA DESC 01 ML (INSULINA) UN 0.0000 0.3058 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00124 LUVA CIRURGICA UN 0.0000 1.4475 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4062 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4062 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4062 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4062 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4062 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4062 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4062 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 01584 NEOSTIGMINA 0,5 MG/ML 1 ML SI IM IV SC AP 0.0000 0.7667 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 01584 NEOSTIGMINA 0,5 MG/ML 1 ML SI IM IV SC AP 0.0000 0.7667 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 01584 NEOSTIGMINA 0,5 MG/ML 1 ML SI IM IV SC AP 0.0000 0.7667 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00170 SORO GLICOSADO 5% 250 ML SI IV BS 0.0000 3.4000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 24082 BROMOPRIDA 5 MG/ML 2 ML SI IM IV AP 0.0000 2.7300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 24082 BROMOPRIDA 5 MG/ML 2 ML SI IM IV AP 0.0000 2.7300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 902001 PLANTAO DE UTI POR PACIENTE (HONORARIO) 0.0000 4558.7200 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4064 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4088 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4088 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4088 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4088 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4088 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4088 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4088 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1766 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1766 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1766 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1766 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1766 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1766 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00090 SERINGA DESC 20 ML UN 0.0000 0.5387 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00090 SERINGA DESC 20 ML UN 0.0000 0.5387 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00090 SERINGA DESC 20 ML UN 0.0000 0.5387 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00090 SERINGA DESC 20 ML UN 0.0000 0.5387 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00090 SERINGA DESC 20 ML UN 0.0000 0.5400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00090 SERINGA DESC 20 ML UN 0.0000 0.5387 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00090 SERINGA DESC 20 ML UN 0.0000 0.5387 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00090 SERINGA DESC 20 ML UN 0.0000 0.5387 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00090 SERINGA DESC 20 ML UN 0.0000 0.5387 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00090 SERINGA DESC 20 ML UN 0.0000 0.5387 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00090 SERINGA DESC 20 ML UN 0.0000 0.5387 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00090 SERINGA DESC 20 ML UN 0.0000 0.5387 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00090 SERINGA DESC 20 ML UN 0.0000 0.5387 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4060 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 11700 EQUIPO P/ BOMBA DE INFUSAO ENTERAL / PARENTERAL 0.0000 8.0200 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 00124 LUVA CIRURGICA UN 0.0000 1.4473 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4074 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4074 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4074 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 00170 SORO GLICOSADO 5% 250 ML SI IV BS 0.0000 3.4000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 25030019 Distúrbios Circulatórios Artério - Venosos e Linfáticos 0.0000 0.0000 NULL EXAME NAO AUTORIZADO 2707
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 25040014 Fisioterapia Respiratória - em Doente Clínico Internado 0.0000 10.0600 NULL EXAME NAO AUTORIZADO 2707
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 29020166 Nebulização Simples com Broncodilatador 0.0000 7.0200 NULL EXAME NAO AUTORIZADO 2707
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 29020166 Nebulização Simples com Broncodilatador 0.0000 7.0200 NULL EXAME NAO AUTORIZADO 2707
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.8089 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.8089 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1775 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1775 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1775 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1775 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1775 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1775 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1775 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1775 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 00124 LUVA CIRURGICA UN 0.0000 1.4476 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 00124 LUVA CIRURGICA UN 0.0000 1.4476 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 00124 LUVA CIRURGICA UN 0.0000 1.4476 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 25040014 Fisioterapia Respiratória - em Doente Clínico Internado 0.0000 10.0600 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 25040014 Fisioterapia Respiratória - em Doente Clínico Internado 0.0000 10.0600 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 35382 COMPRESSAS DE GASES 7.5 X7,5 (11 FIOS ESTERIL) UN 0.0000 0.0000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 35382 COMPRESSAS DE GASES 7.5 X7,5 (11 FIOS ESTERIL) UN 0.0000 0.3000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 35382 COMPRESSAS DE GASES 7.5 X7,5 (11 FIOS ESTERIL) UN 0.0000 0.3000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 35382 COMPRESSAS DE GASES 7.5 X7,5 (11 FIOS ESTERIL) UN 0.0000 0.1909 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 35382 COMPRESSAS DE GASES 7.5 X7,5 (11 FIOS ESTERIL) UN 0.0000 0.3000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 00124 LUVA CIRURGICA UN 0.0000 1.4482 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 00124 LUVA CIRURGICA UN 0.0000 1.4482 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 00124 LUVA CIRURGICA UN 0.0000 1.4482 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 00128 LUVA DE PROCEDIMENTO UNIDADE UN 0.0000 1.6700 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 00128 LUVA DE PROCEDIMENTO UNIDADE UN 0.0000 1.6700 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.4000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.4000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1752 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 51241 AGULHA 123X45 0.0000 0.1900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 51241 AGULHA 123X45 0.0000 0.1900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 51241 AGULHA 123X45 0.0000 0.1900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 51241 AGULHA 123X45 0.0000 0.1900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 51241 AGULHA 123X45 0.0000 0.1900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 51241 AGULHA 123X45 0.0000 0.1900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 51241 AGULHA 123X45 0.0000 0.1900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 51590 ABAIXADOR DE LINGUA UN 0.0000 0.0500 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 52392 SONDA DE ASPIRAÇAO TRAQUEAL C/ VALVULA UN 0.0000 0.9352 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 52392 SONDA DE ASPIRAÇAO TRAQUEAL C/ VALVULA UN 0.0000 0.9352 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 52392 SONDA DE ASPIRAÇAO TRAQUEAL C/ VALVULA UN 0.0000 0.9352 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 52392 SONDA DE ASPIRAÇAO TRAQUEAL C/ VALVULA UN 0.0000 0.9352 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 52392 SONDA DE ASPIRAÇAO TRAQUEAL C/ VALVULA UN 0.0000 0.9400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 52392 SONDA DE ASPIRAÇAO TRAQUEAL C/ VALVULA UN 0.0000 0.9352 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6874 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6874 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6874 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1775 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.3500 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.3500 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 53945 ACIDO ASCORBICO 500 MG CP VO UN 0.0000 0.5900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 53945 ACIDO ASCORBICO 500 MG CP VO UN 0.0000 0.5900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 53945 ACIDO ASCORBICO 500 MG CP VO UN 0.0000 0.5900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 54653 DERSANI LC TP ML 0.0000 0.0000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00128 LUVA DE PROCEDIMENTO UNIDADE UN 0.0000 0.6700 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 01496 FENITOINA 50 MG/ML 5 ML SI IM IV AP 0.0000 2.3400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 01496 FENITOINA 50 MG/ML 5 ML SI IM IV AP 0.0000 2.3400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 01496 FENITOINA 50 MG/ML 5 ML SI IM IV AP 0.0000 2.3400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 01584 NEOSTIGMINA 0,5 MG/ML 1 ML SI IM IV SC AP 0.0000 0.7662 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00169 SORO GLICOSADO 5% 500 ML SI IV BS 0.0000 3.6715 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 24082 BROMOPRIDA 5 MG/ML 2 ML SI IM IV AP 0.0000 2.7300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 24082 BROMOPRIDA 5 MG/ML 2 ML SI IM IV AP 0.0000 2.7300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 24082 BROMOPRIDA 5 MG/ML 2 ML SI IM IV AP 0.0000 2.7300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 26981 SORO FISIOLOGICO 0,9% 10 ML SI IV AP 0.0000 0.9600 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ea4ad2636c25d8e3dbb569ae62db71e7 IONE 12489788840 NULL 12489788840 29020166 Nebulização Simples com Broncodilatador 0.0000 1.2200 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ea4ad2636c25d8e3dbb569ae62db71e7 IONE 12489788840 NULL 12489788840 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 d17b3c5ae418d82694895a326dee545a ODILIA 12670516743 NULL 12670516743 102001 DIARIA DE APARTAMENTO 0.0000 288.8882 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 d17b3c5ae418d82694895a326dee545a ODILIA 12670516743 NULL 12670516743 102001 DIARIA DE APARTAMENTO 0.0000 288.8882 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 d17b3c5ae418d82694895a326dee545a ODILIA 12670516743 NULL 12670516743 01229 FLEET ENEMA (FOSFATO DE SODIO DIBASICO + FOSFATO 0.0000 0.0000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 d17b3c5ae418d82694895a326dee545a ODILIA 12670516743 NULL 12670516743 00128 LUVA DE PROCEDIMENTO UNIDADE UN 0.0000 1.0000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 d17b3c5ae418d82694895a326dee545a ODILIA 12670516743 NULL 12670516743 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 d17b3c5ae418d82694895a326dee545a ODILIA 12670516743 NULL 12670516743 02197 METAMUCIL (PLANTAGO OVATA) 3,4 G PO VO EV 0.0000 2.4600 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 d17b3c5ae418d82694895a326dee545a ODILIA 12670516743 NULL 12670516743 02197 METAMUCIL (PLANTAGO OVATA) 3,4 G PO VO EV 0.0000 2.4600 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 d17b3c5ae418d82694895a326dee545a ODILIA 12670516743 NULL 12670516743 02197 METAMUCIL (PLANTAGO OVATA) 3,4 G PO VO EV 0.0000 2.4600 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 d17b3c5ae418d82694895a326dee545a ODILIA 12670516743 NULL 12670516743 02197 METAMUCIL (PLANTAGO OVATA) 3,4 G PO VO EV 0.0000 2.4600 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 d17b3c5ae418d82694895a326dee545a ODILIA 12670516743 NULL 12670516743 25030019 Distúrbios Circulatórios Artério - Venosos e Linfáticos 0.0000 0.0000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 d17b3c5ae418d82694895a326dee545a ODILIA 12670516743 NULL 12670516743 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 d17b3c5ae418d82694895a326dee545a ODILIA 12670516743 NULL 12670516743 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4074 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4074 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4074 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4074 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4074 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4074 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4074 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4074 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4072 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4072 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 01611 CLORETO DE POTASSIO 600 MG CA VO UN 0.0000 0.4867 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 02246 HIDROCORTISONA 100 MG PO IM IV FA 0.0000 2.8300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 02246 HIDROCORTISONA 100 MG PO IM IV FA 0.0000 2.8300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 02246 HIDROCORTISONA 100 MG PO IM IV FA 0.0000 2.8300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 26981 SORO FISIOLOGICO 0,9% 10 ML SI IV AP 0.0000 0.4800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 00404 LACTULOSE 667 MG/ML XP VO ML 0.0000 0.0000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 00404 LACTULOSE 667 MG/ML XP VO ML 0.0000 0.2100 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 00404 LACTULOSE 667 MG/ML XP VO ML 0.0000 6.4300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 00404 LACTULOSE 667 MG/ML XP VO ML 0.0000 6.4300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1771 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1771 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1771 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1771 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1771 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1771 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1771 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 081fdadb830fb547e83c43fabdb88372 ELZA 12377335349 NULL 12377335349 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 081fdadb830fb547e83c43fabdb88372 ELZA 12377335349 NULL 12377335349 09071 ACETILCISTEINA 600MG PO VO SA 0.0000 3.5000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 081fdadb830fb547e83c43fabdb88372 ELZA 12377335349 NULL 12377335349 09071 ACETILCISTEINA 600MG PO VO SA 0.0000 3.5000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 081fdadb830fb547e83c43fabdb88372 ELZA 12377335349 NULL 12377335349 09071 ACETILCISTEINA 600MG PO VO SA 0.0000 3.5000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 081fdadb830fb547e83c43fabdb88372 ELZA 12377335349 NULL 12377335349 09071 ACETILCISTEINA 600MG PO VO SA 0.0000 3.5000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 081fdadb830fb547e83c43fabdb88372 ELZA 12377335349 NULL 12377335349 00098 ABOCATH N 14 A 22 UN 0.0000 3.7700 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 00172 SORO FISIOLOGICO 0,9% 500 ML SI IV BS 0.0000 9.4698 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 00172 SORO FISIOLOGICO 0,9% 500 ML SI IV BS 0.0000 9.4698 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 02355 AMOXICILINA 1 G + CLAVULANATO 200 MG + DIL. 10 ML 0.0000 36.4600 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 24571 CLINDAMICINA 600 MG 4 ML SI IM IV AP 0.0000 13.0800 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 24571 CLINDAMICINA 600 MG 4 ML SI IM IV AP 0.0000 13.0800 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 24571 CLINDAMICINA 600 MG 4 ML SI IM IV AP 0.0000 13.0800 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR APRESENTADO A MAIOR 1705
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 35382 COMPRESSAS DE GASES 7.5 X7,5 (11 FIOS ESTERIL) UN 0.0000 0.3000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 00406 FUROSEMIDA 10 MG/ML 2 ML SI IM IV AP 0.0000 0.6000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 00406 FUROSEMIDA 10 MG/ML 2 ML SI IM IV AP 0.0000 1.2000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 00487 RANITIDINA 25 MG/ML 2 ML SI IM IV AP 0.0000 0.9300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.8100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.8100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 51379 SERINGA DESC 05 ML UN 0.0000 0.1900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 51379 SERINGA DESC 05 ML UN 0.0000 0.1900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 51379 SERINGA DESC 05 ML UN 0.0000 0.1900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 51379 SERINGA DESC 05 ML UN 0.0000 0.1900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 51497 ESPIRONOLACTONA 50 MG + HIDROCLOROTIAZIDA 50 MG 0.0000 0.9800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 51589 ESPARADRAPO 10 X 4.5 CM CM 0.0000 0.4000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 00541 AMIODARONA 200 MG CP VO UN 0.0000 0.8400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 00541 AMIODARONA 200 MG CP VO UN 0.0000 0.8400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 54685 POLVIDINE ALCOOLICA 0.0000 0.6000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 102001 DIARIA DE APARTAMENTO 0.0000 288.8900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 11325 EQUIPO MACRO-GOTAS FLEXIVEL C/ INJETOR LATERAL UN 0.0000 1.5900 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 11325 EQUIPO MACRO-GOTAS FLEXIVEL C/ INJETOR LATERAL UN 0.0000 3.1800 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 11325 EQUIPO MACRO-GOTAS FLEXIVEL C/ INJETOR LATERAL UN 0.0000 3.1800 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 00128 LUVA DE PROCEDIMENTO UNIDADE UN 0.0000 1.0000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 51649 ALCOOL ETILICO 70 % ST TP ML 0.0000 0.0300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 54995 EQUIPO P/ BOMBA DE INFUSAO ENTERAL / PARENTERAL U UN 0.0000 20.2800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 00090 SERINGA DESC 20 ML UN 0.0000 0.5400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 00090 SERINGA DESC 20 ML UN 0.0000 0.5400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 00090 SERINGA DESC 20 ML UN 0.0000 0.5400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 00943 EQUIPO POLIFIX 2 VIAS UN 0.0000 2.5500 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 f3ad474c8c562757c4d1a959ff0961c4 DJALMA 12718763240 NULL 12718763240 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 f3ad474c8c562757c4d1a959ff0961c4 DJALMA 12718763240 NULL 12718763240 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 f3ad474c8c562757c4d1a959ff0961c4 DJALMA 12718763240 NULL 12718763240 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 f3ad474c8c562757c4d1a959ff0961c4 DJALMA 12718763240 NULL 12718763240 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 f3ad474c8c562757c4d1a959ff0961c4 DJALMA 12718763240 NULL 12718763240 51584 ESPARADRAPO MICROPORE 0.0000 0.2600 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 f3ad474c8c562757c4d1a959ff0961c4 DJALMA 12718763240 NULL 12718763240 51584 ESPARADRAPO MICROPORE 0.0000 0.7700 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 f3ad474c8c562757c4d1a959ff0961c4 DJALMA 12718763240 NULL 12718763240 51584 ESPARADRAPO MICROPORE 0.0000 0.7700 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 f3ad474c8c562757c4d1a959ff0961c4 DJALMA 12718763240 NULL 12718763240 00090 SERINGA DESC 20 ML UN 0.0000 0.5400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 f3ad474c8c562757c4d1a959ff0961c4 DJALMA 12718763240 NULL 12718763240 00090 SERINGA DESC 20 ML UN 0.0000 0.5400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00090 SERINGA DESC 20 ML UN 0.5400 0.2200 0.3200 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00090 SERINGA DESC 20 ML UN 0.5400 0.2200 0.3200 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.6900 0.2700 0.4200 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.6900 0.2700 0.4200 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.6900 0.2700 0.4200 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00128 LUVA DE PROCEDIMENTO UNIDADE UN 1.0000 0.3900 0.6100 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00128 LUVA DE PROCEDIMENTO UNIDADE UN 1.0000 0.3900 0.6100 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 56456 ZOLPIDEM 10 MG CP VO UN 1.2800 0.4900 0.7900 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00493 BROMOPRIDA 5 MG/ML 2 ML SI IM IV AP 2.7300 1.0600 1.6700 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00493 BROMOPRIDA 5 MG/ML 2 ML SI IM IV AP 2.7300 1.0600 1.6700 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00493 BROMOPRIDA 5 MG/ML 2 ML SI IM IV AP 2.7300 1.0600 1.6700 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00493 BROMOPRIDA 5 MG/ML 2 ML SI IM IV AP 2.7300 1.0600 1.6700 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 51673 ALGINATO DE CALCIO EM HIDROGEL GL TP GR 3.4500 1.3400 2.1100 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 51673 ALGINATO DE CALCIO EM HIDROGEL GL TP GR 3.4500 1.3400 2.1100 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00172 SORO FISIOLOGICO 0,9% 500 ML SI IV BS 4.7300 1.8400 2.8900 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 53144 TRAMAL 5.9900 2.3300 3.6600 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 53144 TRAMAL 5.9900 2.3300 3.6600 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 53144 TRAMAL 5.9900 2.3300 3.6600 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 51620 Modulo Em Pó De Fibras Solúveis 7.3100 2.8500 4.4600 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 51673 ALGINATO DE CALCIO EM HIDROGEL GL TP GR 17.2500 6.7300 10.5200 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 51673 ALGINATO DE CALCIO EM HIDROGEL GL TP GR 17.2500 6.7300 10.5200 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 51673 ALGINATO DE CALCIO EM HIDROGEL GL TP GR 17.2500 6.7300 10.5200 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 16b1e9f62f247f02ad5cac910ee15b4e BERCHOLINA 12631612848 NULL 12631612848 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4081 0.0019 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 16b1e9f62f247f02ad5cac910ee15b4e BERCHOLINA 12631612848 NULL 12631612848 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4081 0.0019 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 16b1e9f62f247f02ad5cac910ee15b4e BERCHOLINA 12631612848 NULL 12631612848 36432 HIDROCLOROTIAZIDA 25 MG CP VO UN 0.2400 0.2300 0.0100 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 16b1e9f62f247f02ad5cac910ee15b4e BERCHOLINA 12631612848 NULL 12631612848 00090 SERINGA DESC 20 ML UN 0.5400 0.5200 0.0200 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 05975 COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER 0.3000 0.1500 0.1500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 00817 ALGODAO HIDROFILO BOLINHA UN 0.2600 0.1300 0.1300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 00817 ALGODAO HIDROFILO BOLINHA UN 0.5100 0.1300 0.3800 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 05975 COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER 0.6000 0.1500 0.4500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 37761 ALCOOL ETILICO 70 % ST TP ML 0.0600 0.0200 0.0400 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 33219 LUVA DE PROCEDIMENTO UNIDADE UN 1.6700 0.6700 1.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 33219 LUVA DE PROCEDIMENTO UNIDADE UN 1.6700 0.6700 1.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 37761 ALCOOL ETILICO 70 % ST TP ML 0.0300 0.0000 0.0300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 75bcd473a0dc7c7a6751499b38a4a034 JOAQUIM 12692852143 NULL 12692852143 00817 ALGODAO HIDROFILO BOLINHA UN 0.2600 0.1300 0.1300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 75bcd473a0dc7c7a6751499b38a4a034 JOAQUIM 12692852143 NULL 12692852143 37761 ALCOOL ETILICO 70 % ST TP ML 0.0300 0.0200 0.0100 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 4668d2494ed6c4b2d18be299efcb26a2 JOAO 12469689344 NULL 12469689344 08648 ESPARADRAPO 10 X 4.5 CM CM 2.0000 1.2800 0.7200 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 4668d2494ed6c4b2d18be299efcb26a2 JOAO 12469689344 NULL 12469689344 08664 ESPARADRAPO MICROPORE 50 X 10 CM CM 0.7700 0.2600 0.5100 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 4668d2494ed6c4b2d18be299efcb26a2 JOAO 12469689344 NULL 12469689344 08648 ESPARADRAPO 10 X 4.5 CM CM 0.4000 0.2600 0.1400 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 4668d2494ed6c4b2d18be299efcb26a2 JOAO 12469689344 NULL 12469689344 17310 IODOPOVIDONA ALCOOLICA SL TP ML 0.6000 0.3000 0.3000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 37761 ALCOOL ETILICO 70 % ST TP ML 0.0600 0.0300 0.0300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 12572 KIT CATETER DUPLO LUMEM P/ HEMODIALISE UN 183.0000 0.0000 183.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 19151 SERINGA DESC 10 ML UN 0.3300 0.0000 0.3300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.0000 0.1000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 33219 LUVA DE PROCEDIMENTO UNIDADE UN 1.0000 0.6700 0.3300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 05975 COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER 0.3000 0.0000 0.3000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 00817 ALGODAO HIDROFILO BOLINHA UN 0.2600 0.1300 0.1300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 33219 LUVA DE PROCEDIMENTO UNIDADE UN 1.0000 0.6700 0.3300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 00817 ALGODAO HIDROFILO BOLINHA UN 0.2600 0.1300 0.1300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 32891 EQUIPO POLIFIX 2ş VIAS UN 2.5500 0.0000 2.5500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 28959 DERSANI LC TP ML 19.4000 9.7000 9.7000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 33219 LUVA DE PROCEDIMENTO UNIDADE UN 1.0000 0.6700 0.3300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 11940 INSULINA NPH/REGULAR SI SC UI 0.4000 0.0000 0.4000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 32891 EQUIPO POLIFIX 2ş VIAS UN 2.5500 0.0000 2.5500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 53660 EQUIPO MACRO-GOTAS FLEXIVEL C/ INJETOR LATE 1.5900 0.0000 1.5900 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12558131243 NULL 12558131243 11193 CLOREXIDINA 2 % ST TP ML 0.5300 0.2700 0.2600 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00817 ALGODAO HIDROFILO BOLINHA UN 0.2600 0.1300 0.1300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 7c2bc8cd9bbf9ce081562a3c63fff8c9 MARTA 12647505849 NULL 12647505849 19160 SERINGA DESC 20 ML UN 0.5400 0.5300 0.0000 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 7c2bc8cd9bbf9ce081562a3c63fff8c9 MARTA 12647505849 NULL 12647505849 22896 CEFUROXIMA 750 MG + DIL. 6 ML PO IM IV FA 26.1300 26.1250 0.0050 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 7c2bc8cd9bbf9ce081562a3c63fff8c9 MARTA 12647505849 NULL 12647505849 22896 CEFUROXIMA 750 MG + DIL. 6 ML PO IM IV FA 26.1300 26.1250 0.0050 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 7c2bc8cd9bbf9ce081562a3c63fff8c9 MARTA 12647505849 NULL 12647505849 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1756 0.0044 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 f65f553befc0e3bc8bd5bce5c1c6e413 NAIRLENE 12633078944 NULL 12633078944 33219 LUVA DE PROCEDIMENTO UNIDADE UN 1.6700 1.6650 0.0050 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 f65f553befc0e3bc8bd5bce5c1c6e413 NAIRLENE 12633078944 NULL 12633078944 19160 SERINGA DESC 20 ML UN 0.5400 0.5367 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 f65f553befc0e3bc8bd5bce5c1c6e413 NAIRLENE 12633078944 NULL 12633078944 19160 SERINGA DESC 20 ML UN 0.5400 0.5367 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 f65f553befc0e3bc8bd5bce5c1c6e413 NAIRLENE 12633078944 NULL 12633078944 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4062 0.0038 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 f65f553befc0e3bc8bd5bce5c1c6e413 NAIRLENE 12633078944 NULL 12633078944 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4067 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 f65f553befc0e3bc8bd5bce5c1c6e413 NAIRLENE 12633078944 NULL 12633078944 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4067 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 f65f553befc0e3bc8bd5bce5c1c6e413 NAIRLENE 12633078944 NULL 12633078944 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1760 0.0040 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 f65f553befc0e3bc8bd5bce5c1c6e413 NAIRLENE 12633078944 NULL 12633078944 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1760 0.0040 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 f65f553befc0e3bc8bd5bce5c1c6e413 NAIRLENE 12633078944 NULL 12633078944 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1760 0.0040 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 f65f553befc0e3bc8bd5bce5c1c6e413 NAIRLENE 12633078944 NULL 12633078944 07269 DIPIRONA 500 MG/ML 2 ML SI IV IM AP 0.6900 0.6867 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 f93cee6f501560245a8f94ffc5c6c246 ROSEDALIA 12622895145 NULL 12622895145 19160 SERINGA DESC 20 ML UN 0.5400 0.5373 0.0027 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 f93cee6f501560245a8f94ffc5c6c246 ROSEDALIA 12622895145 NULL 12622895145 19160 SERINGA DESC 20 ML UN 0.5400 0.5373 0.0027 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 026c6dcfddc3d74250c79f449289696a SALOMAO 12456038443 NULL 12456038443 12262 ISOSSORBIDA 20 MG CP VO UN 0.2200 0.2150 0.0050 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 026c6dcfddc3d74250c79f449289696a SALOMAO 12456038443 NULL 12456038443 12262 ISOSSORBIDA 20 MG CP VO UN 0.2200 0.2150 0.0050 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 d4089ccef13567fd45b16fb0b60685fa VERA 12640482546 NULL 12640482546 08664 ESPARADRAPO MICROPORE 50 X 10 CM CM 0.7700 0.7600 0.0000 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 d4089ccef13567fd45b16fb0b60685fa VERA 12640482546 NULL 12640482546 27480 CLARITROMICINA 500 MG 30 ML PO IV FA 117.1100 117.1050 0.0050 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 d4089ccef13567fd45b16fb0b60685fa VERA 12640482546 NULL 12640482546 27480 CLARITROMICINA 500 MG 30 ML PO IV FA 117.1100 117.1050 0.0050 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 d4089ccef13567fd45b16fb0b60685fa VERA 12640482546 NULL 12640482546 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1754 0.0046 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 d4089ccef13567fd45b16fb0b60685fa VERA 12640482546 NULL 12640482546 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1754 0.0046 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 d4089ccef13567fd45b16fb0b60685fa VERA 12640482546 NULL 12640482546 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1754 0.0046 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 d4089ccef13567fd45b16fb0b60685fa VERA 12640482546 NULL 12640482546 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1754 0.0046 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4074 0.0026 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4074 0.0026 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 19160 SERINGA DESC 20 ML UN 0.5400 0.5372 0.0028 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 19160 SERINGA DESC 20 ML UN 0.5400 0.5372 0.0028 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 19160 SERINGA DESC 20 ML UN 0.5400 0.5372 0.0028 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 19160 SERINGA DESC 20 ML UN 0.5400 0.5372 0.0028 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 19160 SERINGA DESC 20 ML UN 0.5400 0.5372 0.0028 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1d6bbb4a00130e2e654e830fc9bae6a ALEXANDRINA 12694224940 NULL 12694224940 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4076 0.0024 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1d6bbb4a00130e2e654e830fc9bae6a ALEXANDRINA 12694224940 NULL 12694224940 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4072 0.0028 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1d6bbb4a00130e2e654e830fc9bae6a ALEXANDRINA 12694224940 NULL 12694224940 19160 SERINGA DESC 20 ML UN 0.5400 0.5367 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1d6bbb4a00130e2e654e830fc9bae6a ALEXANDRINA 12694224940 NULL 12694224940 19160 SERINGA DESC 20 ML UN 0.5400 0.5367 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 345c226bfea274af1372d41b0305a6c8 ALTINO 12720257940 NULL 12720257940 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1000 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1038 -0.0038 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1038 -0.0038 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1038 -0.0038 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1038 -0.0038 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1038 -0.0038 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1038 -0.0038 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1038 -0.0038 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 19160 SERINGA DESC 20 ML UN 0.5400 0.5378 0.0022 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 19160 SERINGA DESC 20 ML UN 0.5400 0.5378 0.0022 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 19160 SERINGA DESC 20 ML UN 0.5400 0.5378 0.0022 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 19160 SERINGA DESC 20 ML UN 0.5400 0.5378 0.0022 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1797 0.0003 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1797 0.0003 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1900 0.1797 0.0103 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.4000 0.4045 -0.0045 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.4000 0.4045 -0.0045 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8091 0.0009 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8091 0.0009 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 08435 EQUIPO P/ BOMBA DE INFUSAO ENTERAL / PARENT 20.2800 20.2780 0.0020 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 20567 SORO FISIOLOGICO 0,9% 500 ML SI IV BS 4.7300 4.7350 -0.0050 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 670141098c0309ac9be3db204bdc12cf LEOSINA 12706525442 NULL 12706525442 02461 FENOTEROL 2 MG/ML 10 ML AE IN DS 0.4300 0.4250 0.0050 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 32891 EQUIPO POLIFIX 2ş VIAS UN 5.1000 0.0000 5.1000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 27480 CLARITROMICINA 500 MG 30 ML PO IV FA 117.1100 117.1050 0.0050 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 27480 CLARITROMICINA 500 MG 30 ML PO IV FA 117.1100 117.1050 0.0050 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 27480 CLARITROMICINA 500 MG 30 ML PO IV FA 117.1100 117.1050 0.0050 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 07269 DIPIRONA 500 MG/ML 2 ML SI IV IM AP 0.6900 0.6850 0.0050 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 07269 DIPIRONA 500 MG/ML 2 ML SI IV IM AP 0.6900 0.6850 0.0050 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1758 0.0042 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1758 0.0042 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1758 0.0042 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1758 0.0042 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4084 0.0016 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4084 0.0016 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4084 0.0016 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 19160 SERINGA DESC 20 ML UN 0.5400 0.5384 0.0016 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 19160 SERINGA DESC 20 ML UN 0.5400 0.5384 0.0016 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 19160 SERINGA DESC 20 ML UN 0.5400 0.5384 0.0016 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 19160 SERINGA DESC 20 ML UN 0.5400 0.5384 0.0016 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 19445 CLORETO DE POTASSIO 600 MG CA VO UN 0.4900 0.4867 0.0033 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 19445 CLORETO DE POTASSIO 600 MG CA VO UN 0.4900 0.4867 0.0033 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 19445 CLORETO DE POTASSIO 600 MG CA VO UN 0.4900 0.4867 0.0033 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4075 0.0025 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4075 0.0025 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4075 0.0025 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4075 0.0025 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 07269 DIPIRONA 500 MG/ML 2 ML SI IV IM AP 0.6900 0.6865 0.0035 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 07269 DIPIRONA 500 MG/ML 2 ML SI IV IM AP 0.6900 0.6865 0.0035 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 07269 DIPIRONA 500 MG/ML 2 ML SI IV IM AP 0.6900 0.6865 0.0035 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 07269 DIPIRONA 500 MG/ML 2 ML SI IV IM AP 0.6900 0.6865 0.0035 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 07269 DIPIRONA 500 MG/ML 2 ML SI IV IM AP 0.6900 0.6865 0.0035 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 07269 DIPIRONA 500 MG/ML 2 ML SI IV IM AP 0.6900 0.6865 0.0035 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 07269 DIPIRONA 500 MG/ML 2 ML SI IV IM AP 0.6900 0.6865 0.0035 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 19160 SERINGA DESC 20 ML UN 0.5400 0.5375 0.0025 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 19160 SERINGA DESC 20 ML UN 0.5400 0.5375 0.0025 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1761 0.0039 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1769 0.0031 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1769 0.0031 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1769 0.0031 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1769 0.0031 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1769 0.0031 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1769 0.0031 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8073 0.0027 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 33227 LUVA CIRURGICA PAR UN 1.4500 1.4477 0.0023 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 19160 SERINGA DESC 20 ML UN 0.5400 0.5372 0.0028 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 19160 SERINGA DESC 20 ML UN 0.5400 0.5372 0.0028 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 19160 SERINGA DESC 20 ML UN 0.5400 0.5372 0.0028 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 19160 SERINGA DESC 20 ML UN 0.5400 0.5372 0.0028 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 19160 SERINGA DESC 20 ML UN 0.5400 0.5372 0.0028 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 19160 SERINGA DESC 20 ML UN 0.5400 0.5372 0.0028 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 19160 SERINGA DESC 20 ML UN 0.5400 0.5372 0.0028 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1779 0.0021 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1779 0.0021 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1779 0.0021 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1779 0.0021 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1779 0.0021 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1779 0.0021 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1779 0.0021 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 11193 CLOREXIDINA 2 % ST TP ML 0.5300 0.5320 -0.0020 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 08664 ESPARADRAPO MICROPORE 50 X 10 CM CM 0.2600 0.2558 0.0042 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 08664 ESPARADRAPO MICROPORE 50 X 10 CM CM 0.2600 0.2558 0.0042 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 08664 ESPARADRAPO MICROPORE 50 X 10 CM CM 0.2600 0.2558 0.0042 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 08664 ESPARADRAPO MICROPORE 50 X 10 CM CM 0.2600 0.2558 0.0042 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 08664 ESPARADRAPO MICROPORE 50 X 10 CM CM 0.2600 0.2558 0.0042 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 08664 ESPARADRAPO MICROPORE 50 X 10 CM CM 0.2600 0.2558 0.0042 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 08664 ESPARADRAPO MICROPORE 50 X 10 CM CM 0.2600 0.2558 0.0042 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 19135 SERINGA DESC 03 ML UN 0.3000 0.0000 0.3000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 19135 SERINGA DESC 03 ML UN 0.1500 0.0000 0.1500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 19135 SERINGA DESC 03 ML UN 0.1500 0.0000 0.1500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 19135 SERINGA DESC 03 ML UN 0.1500 0.0000 0.1500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 19135 SERINGA DESC 03 ML UN 0.1500 0.0000 0.1500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 6ccea6ac8c216c032723aee73a9f81c9 PRISCILA 12662249242 NULL 12662249242 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.3500 0.3400 0.0000 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 6ccea6ac8c216c032723aee73a9f81c9 PRISCILA 12662249242 NULL 12662249242 20672 SORO RINGER SIMPLES 500 ML SI IV BS 5.9400 5.9375 0.0025 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 6ccea6ac8c216c032723aee73a9f81c9 PRISCILA 12662249242 NULL 12662249242 19160 SERINGA DESC 20 ML UN 0.5400 0.5373 0.0027 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 6ccea6ac8c216c032723aee73a9f81c9 PRISCILA 12662249242 NULL 12662249242 19160 SERINGA DESC 20 ML UN 0.5400 0.5373 0.0027 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 6ccea6ac8c216c032723aee73a9f81c9 PRISCILA 12662249242 NULL 12662249242 19160 SERINGA DESC 20 ML UN 0.5400 0.5373 0.0027 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 6ccea6ac8c216c032723aee73a9f81c9 PRISCILA 12662249242 NULL 12662249242 19160 SERINGA DESC 20 ML UN 0.5400 0.5373 0.0027 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1000 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1000 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1000 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1000 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1000 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1000 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1000 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1000 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1000 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 1.2100 0.0000 1.2100 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 1.6200 0.0000 1.6200 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 33227 LUVA CIRURGICA PAR UN 1.4500 1.4476 0.0024 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 33227 LUVA CIRURGICA PAR UN 1.4500 1.4476 0.0024 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 33227 LUVA CIRURGICA PAR UN 1.4500 1.4476 0.0024 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 19160 SERINGA DESC 20 ML UN 0.5400 0.5384 0.0016 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 19160 SERINGA DESC 20 ML UN 0.5400 0.5384 0.0016 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 19160 SERINGA DESC 20 ML UN 0.5400 0.5384 0.0016 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 32891 EQUIPO POLIFIX 2ş VIAS UN 2.5500 2.5500 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1776 0.0024 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1776 0.0024 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1776 0.0024 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 6799aa3de305405ab065aad5b599765c VANIR 12700232345 NULL 12700232345 07269 DIPIRONA 500 MG/ML 2 ML SI IV IM AP 0.6900 0.6870 0.0030 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 05975 COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER 0.6000 0.6000 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 29661 NOREPINEFRINA 2 MG/ML 4 ML SI IV AP 37.9900 37.9850 0.0050 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 29661 NOREPINEFRINA 2 MG/ML 4 ML SI IV AP 151.9400 151.9400 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8079 0.0021 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8079 0.0021 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8079 0.0021 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8079 0.0021 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8079 0.0021 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8079 0.0021 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 08435 EQUIPO P/ BOMBA DE INFUSAO ENTERAL / PARENT 20.2800 20.2775 0.0025 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 75bcd473a0dc7c7a6751499b38a4a034 JOAQUIM 12692852143 NULL 12692852143 53660 EQUIPO MACRO-GOTAS FLEXIVEL C/ INJETOR LATE 1.5900 1.5900 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 610c198ec4c064687cf0524f147d3aed ROBERTO 12748814743 NULL 12748814743 19143 SERINGA DESC 05 ML UN 0.7700 0.7680 0.0020 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 610c198ec4c064687cf0524f147d3aed ROBERTO 12748814743 NULL 12748814743 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1767 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 610c198ec4c064687cf0524f147d3aed ROBERTO 12748814743 NULL 12748814743 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1767 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 610c198ec4c064687cf0524f147d3aed ROBERTO 12748814743 NULL 12748814743 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1767 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 610c198ec4c064687cf0524f147d3aed ROBERTO 12748814743 NULL 12748814743 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4083 0.0017 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 610c198ec4c064687cf0524f147d3aed ROBERTO 12748814743 NULL 12748814743 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4083 0.0017 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 610c198ec4c064687cf0524f147d3aed ROBERTO 12748814743 NULL 12748814743 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4083 0.0017 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 610c198ec4c064687cf0524f147d3aed ROBERTO 12748814743 NULL 12748814743 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4083 0.0017 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 610c198ec4c064687cf0524f147d3aed ROBERTO 12748814743 NULL 12748814743 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4083 0.0017 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 610c198ec4c064687cf0524f147d3aed ROBERTO 12748814743 NULL 12748814743 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4083 0.0017 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12647284040 NULL 12647284040 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1750 0.0050 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12647284040 NULL 12647284040 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4086 0.0014 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 08435 EQUIPO P/ BOMBA DE INFUSAO ENTERAL / PARENT 20.2800 20.2775 0.0025 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 33545 PIPERACILINA 4 G + TAZOBACTAM 500 MG PO IV 83.4500 83.4500 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 33545 PIPERACILINA 4 G + TAZOBACTAM 500 MG PO IV 83.4500 83.4500 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 33545 PIPERACILINA 4 G + TAZOBACTAM 500 MG PO IV 83.4500 83.4500 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 33545 PIPERACILINA 4 G + TAZOBACTAM 500 MG PO IV 83.4500 83.4500 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 33545 PIPERACILINA 4 G + TAZOBACTAM 500 MG PO IV 83.4500 83.4500 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 33545 PIPERACILINA 4 G + TAZOBACTAM 500 MG PO IV 83.4500 83.4500 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 6.8145 -3.4045 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 6.8145 -3.4045 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 6.8145 -3.4045 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 6.8145 -3.4045 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 6.8145 -3.4045 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4072 0.0028 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4072 0.0028 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4072 0.0028 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4072 0.0028 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4072 0.0028 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 33227 LUVA CIRURGICA PAR UN 2.9000 2.9000 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.2120 -0.1120 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.2120 -0.1120 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.2120 -0.1120 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 19160 SERINGA DESC 20 ML UN 0.5400 0.5374 0.0026 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 19160 SERINGA DESC 20 ML UN 0.5400 0.5374 0.0026 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 19160 SERINGA DESC 20 ML UN 0.5400 0.5374 0.0026 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 19160 SERINGA DESC 20 ML UN 0.5400 0.5374 0.0026 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 19160 SERINGA DESC 20 ML UN 0.5400 0.5374 0.0026 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 19160 SERINGA DESC 20 ML UN 0.5400 0.5374 0.0026 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 19160 SERINGA DESC 20 ML UN 0.5400 0.5374 0.0026 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 19160 SERINGA DESC 20 ML UN 0.5400 0.5374 0.0026 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.4000 0.4037 -0.0037 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.4000 0.4037 -0.0037 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.4000 0.4037 -0.0037 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.4000 0.4037 -0.0037 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8073 0.0027 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8073 0.0027 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8073 0.0027 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8073 0.0027 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 33219 LUVA DE PROCEDIMENTO UNIDADE UN 1.3300 1.3400 -0.0100 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 33219 LUVA DE PROCEDIMENTO UNIDADE UN 1.3300 1.3400 -0.0100 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 09636 FLORATIL (SACCHAROMYCES BOULARDII) 200 MG P 4.4400 8.8851 -4.4451 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 09636 FLORATIL (SACCHAROMYCES BOULARDII) 200 MG P 4.4400 8.8851 -4.4451 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 09636 FLORATIL (SACCHAROMYCES BOULARDII) 200 MG P 4.4400 8.8851 -4.4451 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 09636 FLORATIL (SACCHAROMYCES BOULARDII) 200 MG P 4.4400 8.8851 -4.4451 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 27600 ONDANSETRONA 2 MG/ML 4 ML SI IM IV AP 81.1800 94.7100 -81.1800 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 27600 ONDANSETRONA 2 MG/ML 4 ML SI IM IV AP 81.1800 94.7100 -81.1800 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 05975 COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER 0.8039 0.8369 -0.7769 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 05975 COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER 1.3439 1.3948 -0.7948 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 28959 DERSANI LC TP ML 5.8200 6.7900 -4.8500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 08664 ESPARADRAPO MICROPORE 50 X 10 CM CM 1.1064 1.1285 -0.8685 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 08664 ESPARADRAPO MICROPORE 50 X 10 CM CM 1.1064 1.1285 -0.8685 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 08664 ESPARADRAPO MICROPORE 50 X 10 CM CM 1.3564 1.3849 -0.8749 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 08664 ESPARADRAPO MICROPORE 50 X 10 CM CM 1.3564 1.3849 -0.8749 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 08664 ESPARADRAPO MICROPORE 50 X 10 CM CM 1.3564 1.3849 -0.8749 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1d6bbb4a00130e2e654e830fc9bae6a ALEXANDRINA 12694224940 NULL 12694224940 05274 AMOXICILINA 500 MG + CLAVULANATO 125 MG CP 3.1700 3.1666 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1d6bbb4a00130e2e654e830fc9bae6a ALEXANDRINA 12694224940 NULL 12694224940 05274 AMOXICILINA 500 MG + CLAVULANATO 125 MG CP 3.1700 3.1667 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 03280 CLOREXIDINA 2 % ST TP ML NULL 0.0000 NULL OPME INVALIDO 2201
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 03280 CLOREXIDINA 2 % ST TP ML NULL 0.0000 NULL OPME INVALIDO 2201
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 03280 CLOREXIDINA 2 % ST TP ML NULL 0.0000 NULL OPME INVALIDO 2201
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 52733 SERINGA DESC 20 ML UN NULL 0.0000 NULL OPME INVALIDO 2201
Glosa Min 2018-10-03 00:00:00.000000 1084117 800720d33fe0defb6121e82dd216d044 JALMO 12786952647 NULL 12786952647 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 800720d33fe0defb6121e82dd216d044 JALMO 12786952647 NULL 12786952647 00757 CEFUROXIMA 750 MG + DIL. 6 ML PO IM IV FA 0.0000 26.1300 NULL VALOR APRESENTADO A MAIOR 1705
Glosa Min 2018-10-03 00:00:00.000000 1084117 800720d33fe0defb6121e82dd216d044 JALMO 12786952647 NULL 12786952647 00757 CEFUROXIMA 750 MG + DIL. 6 ML PO IM IV FA 0.0000 26.1300 NULL VALOR APRESENTADO A MAIOR 1705
Glosa Min 2018-10-03 00:00:00.000000 1084117 800720d33fe0defb6121e82dd216d044 JALMO 12786952647 NULL 12786952647 00090 SERINGA DESC 20 ML UN 0.0000 0.5400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 752c651cb4fd049e19c685f87fbe8bdc EDUARDO 12765990646 NULL 12765990646 25030019 Distúrbios Circulatórios Artério - Venosos e Linfáticos 0.0000 57.3200 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 752c651cb4fd049e19c685f87fbe8bdc EDUARDO 12765990646 NULL 12765990646 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6875 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 752c651cb4fd049e19c685f87fbe8bdc EDUARDO 12765990646 NULL 12765990646 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6875 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 752c651cb4fd049e19c685f87fbe8bdc EDUARDO 12765990646 NULL 12765990646 51241 AGULHA 123X45 0.0000 0.1900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 752c651cb4fd049e19c685f87fbe8bdc EDUARDO 12765990646 NULL 12765990646 53975 Hemifumarato De Quetiapina 25mg ? Cp 0.0000 1.2450 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 752c651cb4fd049e19c685f87fbe8bdc EDUARDO 12765990646 NULL 12765990646 53975 Hemifumarato De Quetiapina 25mg ? Cp 0.0000 1.2450 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12558131243 NULL 12558131243 52010341 Hérnia Discal - Tratamento Cirúrgico 0.0000 0.0000 NULL COBRANCA DE HONORARIOS EM DUPLICIDADE 2607
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12558131243 NULL 12558131243 55193 Beriplast P Selant De Fibrina 1 Ml Po Ou Fr 0.0000 1125.8740 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 526685c1041cc1316e874a2e95e67e2e JOSE 12696604949 NULL 12696604949 00172 SORO FISIOLOGICO 0,9% 500 ML SI IV BS 0.0000 4.7300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 11232 CLEXANE (ENOXAPARINA) 40 MG SI IV SC SE 0.0000 38.9400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 11232 CLEXANE (ENOXAPARINA) 40 MG SI IV SC SE 0.0000 38.9400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 11700 EQUIPO P/ BOMBA DE INFUSAO ENTERAL / PARENTERAL 0.0000 0.0000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 11700 EQUIPO P/ BOMBA DE INFUSAO ENTERAL / PARENTERAL 0.0000 0.0000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 11700 EQUIPO P/ BOMBA DE INFUSAO ENTERAL / PARENTERAL 0.0000 20.2800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 11700 EQUIPO P/ BOMBA DE INFUSAO ENTERAL / PARENTERAL 0.0000 20.2800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.0000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.4000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.4000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.4000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.0000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 51379 SERINGA DESC 05 ML UN 0.0000 0.1900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 51379 SERINGA DESC 05 ML UN 0.0000 0.1900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 51434 BECLOMETASONA 400 MCG / ML 2 ML SL IN FL 0.0000 4.4800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 51434 BECLOMETASONA 400 MCG / ML 2 ML SL IN FL 0.0000 4.4800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 51660 BROMETO DE IPRATROPIO SL IN GT 0.0000 0.0000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00613 CLINDAMICINA 600 MG 4 ML SI IM IV AP 0.0000 13.0800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00943 EQUIPO POLIFIX 2 VIAS UN 0.0000 5.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 4e13adf421809cb755e1bdd80cc4efed AGRIPINA 12385409142 NULL 12385409142 39040259 Revascularização Arterial de Membro Superior Qualquer Tipo 0.0000 0.0900 NULL COBRANCA DE HONORARIOS EM DUPLICIDADE 2607
Glosa Min 2018-10-03 00:00:00.000000 1084117 75bcd473a0dc7c7a6751499b38a4a034 JOAQUIM 12692852143 NULL 12692852143 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4075 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 75bcd473a0dc7c7a6751499b38a4a034 JOAQUIM 12692852143 NULL 12692852143 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4075 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 75bcd473a0dc7c7a6751499b38a4a034 JOAQUIM 12692852143 NULL 12692852143 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 75bcd473a0dc7c7a6751499b38a4a034 JOAQUIM 12692852143 NULL 12692852143 25040014 Fisioterapia Respiratória - em Doente Clínico Internado 0.0000 30.1700 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 75bcd473a0dc7c7a6751499b38a4a034 JOAQUIM 12692852143 NULL 12692852143 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 75bcd473a0dc7c7a6751499b38a4a034 JOAQUIM 12692852143 NULL 12692852143 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6850 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 75bcd473a0dc7c7a6751499b38a4a034 JOAQUIM 12692852143 NULL 12692852143 04073 TRAMADOL 50 MG 1 ML SI IM IV AP 0.0000 4.1900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 75bcd473a0dc7c7a6751499b38a4a034 JOAQUIM 12692852143 NULL 12692852143 04073 TRAMADOL 50 MG 1 ML SI IM IV AP 0.0000 4.1900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 75bcd473a0dc7c7a6751499b38a4a034 JOAQUIM 12692852143 NULL 12692852143 51710 CLORETO DE POTASSIO 15% 10 ML SI IV AP 0.0000 0.6900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00124 LUVA CIRURGICA UN 0.0000 1.4475 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00124 LUVA CIRURGICA UN 0.0000 1.4475 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00124 LUVA CIRURGICA UN 0.0000 1.4475 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00124 LUVA CIRURGICA UN 0.0000 1.4475 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 24082 BROMOPRIDA 5 MG/ML 2 ML SI IM IV AP 0.0000 2.7300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 26981 SORO FISIOLOGICO 0,9% 10 ML SI IV AP 0.0000 0.4800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6875 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6875 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00487 RANITIDINA 25 MG/ML 2 ML SI IM IV AP 0.0000 0.9300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00487 RANITIDINA 25 MG/ML 2 ML SI IM IV AP 0.0000 0.9300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00487 RANITIDINA 25 MG/ML 2 ML SI IM IV AP 0.0000 0.9300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00487 RANITIDINA 25 MG/ML 2 ML SI IM IV AP 0.0000 0.9300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00487 RANITIDINA 25 MG/ML 2 ML SI IM IV AP 0.0000 0.9300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 51578 Frasco p/ alimentacao enteral 0.0000 2.4700 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 51578 Frasco p/ alimentacao enteral 0.0000 2.4700 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 51578 Frasco p/ alimentacao enteral 0.0000 2.4700 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 51584 ESPARADRAPO MICROPORE 0.0000 0.2560 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 51584 ESPARADRAPO MICROPORE 0.0000 0.2600 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 51584 ESPARADRAPO MICROPORE 0.0000 0.2560 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 54756 HIDANTAL 0.0000 0.1864 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 54756 HIDANTAL 0.0000 0.1864 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 55795 FOSFATO DE POTASSIO 2 MEQ/ML 10 ML SI IV AP 0.0000 3.0200 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00069 SERINGA DESC 10 ML UN 0.0000 0.9975 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00796 FLORATIL (SACCHAROMYCES BOULARDII) 200 MG PO VO 0.0000 4.4400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4088 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4088 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4088 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4088 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4088 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4088 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4088 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4088 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4088 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4088 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4088 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4088 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4088 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4088 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6872 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6872 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6872 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6872 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 51040204 Sinusectomia (Maxilar, Etmoidal ou Esfenoidal) Endoscópica ou por Microscopia, Via Endonasal 0.0000 0.0000 NULL EXAME SEM REGISTRO DE EXECUCAO 2703
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 1.4591 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 6.4600 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1766 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1766 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1766 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4070 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4070 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 22421 PIPERACILINA 2 G + TAZOBACTAM 250 MG 30 ML PO IV 0.0000 55.3400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 02246 HIDROCORTISONA 100 MG PO IM IV FA 0.0000 8.5000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.4000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 51584 ESPARADRAPO MICROPORE 0.0000 0.2560 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 52303 NOREPINEFRINA 2 MG/ML 4 ML SI IV AP 0.0000 94.9600 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 52303 NOREPINEFRINA 2 MG/ML 4 ML SI IV AP 0.0000 28.4900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cd2840524be5a3f1d0939f241e24f32b MARIA 12705908340 NULL 12705908340 101001 DIARIA DE ENFERMARIA 0.0000 173.3200 NULL EXAME SEM REGISTRO DE EXECUCAO 2703
Glosa Min 2018-10-03 00:00:00.000000 1084117 cd2840524be5a3f1d0939f241e24f32b MARIA 12705908340 NULL 12705908340 00184 CLORETO DE POTASSIO 10% 10 ML SI IV AP 0.0000 0.2964 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cd2840524be5a3f1d0939f241e24f32b MARIA 12705908340 NULL 12705908340 00184 CLORETO DE POTASSIO 10% 10 ML SI IV AP 0.0000 0.2967 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cd2840524be5a3f1d0939f241e24f32b MARIA 12705908340 NULL 12705908340 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cd2840524be5a3f1d0939f241e24f32b MARIA 12705908340 NULL 12705908340 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cd2840524be5a3f1d0939f241e24f32b MARIA 12705908340 NULL 12705908340 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 00090 SERINGA DESC 20 ML UN 0.0000 0.5383 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 00090 SERINGA DESC 20 ML UN 0.0000 0.5379 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 00090 SERINGA DESC 20 ML UN 0.0000 0.5379 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 00090 SERINGA DESC 20 ML UN 0.0000 0.5379 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 15d5767e884047dd75e619035a17061a JUSCELINO 12768581943 NULL 12768581943 000445 TAXA DE TRANSPORTE E INSTALACAO DE EQUIPAMENTO DE 0.0000 0.0100 NULL TAXA / ALUGUEL INVALIDO 2401
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 101001 DIARIA DE ENFERMARIA 0.0000 173.3200 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 01611 CLORETO DE POTASSIO 600 MG CA VO UN 0.0000 0.4861 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 01611 CLORETO DE POTASSIO 600 MG CA VO UN 0.0000 0.4867 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.8078 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.8078 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.8078 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1773 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1773 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1773 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1773 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1773 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1773 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 00090 SERINGA DESC 20 ML UN 0.0000 0.5376 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4094 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4094 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4094 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4094 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4094 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 01496 FENITOINA 50 MG/ML 5 ML SI IM IV AP 0.0000 2.3400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 02246 HIDROCORTISONA 100 MG PO IM IV FA 0.0000 2.8300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 26981 SORO FISIOLOGICO 0,9% 10 ML SI IV AP 0.0000 0.4800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 26981 SORO FISIOLOGICO 0,9% 10 ML SI IV AP 0.0000 0.4800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 26981 SORO FISIOLOGICO 0,9% 10 ML SI IV AP 0.0000 0.4800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 26981 SORO FISIOLOGICO 0,9% 10 ML SI IV AP 0.0000 0.9600 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 26981 SORO FISIOLOGICO 0,9% 10 ML SI IV AP 0.0000 0.9600 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 26981 SORO FISIOLOGICO 0,9% 10 ML SI IV AP 0.0000 0.9600 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 26981 SORO FISIOLOGICO 0,9% 10 ML SI IV AP 0.0000 0.9600 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 26981 SORO FISIOLOGICO 0,9% 10 ML SI IV AP 0.0000 0.9600 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 26981 SORO FISIOLOGICO 0,9% 10 ML SI IV AP 0.0000 0.9600 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 26981 SORO FISIOLOGICO 0,9% 10 ML SI IV AP 0.0000 0.9600 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 26981 SORO FISIOLOGICO 0,9% 10 ML SI IV AP 0.0000 0.9600 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 26981 SORO FISIOLOGICO 0,9% 10 ML SI IV AP 0.0000 0.9600 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 26981 SORO FISIOLOGICO 0,9% 10 ML SI IV AP 0.0000 0.9600 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 26981 SORO FISIOLOGICO 0,9% 10 ML SI IV AP 0.0000 0.9600 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 09070 ACETILCISTEINA 600MG PO VO SA 0.0000 3.4950 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 09070 ACETILCISTEINA 600MG PO VO SA 0.0000 3.4950 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 09070 ACETILCISTEINA 600MG PO VO SA 0.0000 3.4950 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 09070 ACETILCISTEINA 600MG PO VO SA 0.0000 3.5000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 00091 SERINGA DESC 01 ML (INSULINA) UN 0.0000 0.3100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 00091 SERINGA DESC 01 ML (INSULINA) UN 0.0000 0.3100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 15f461c0ca379f375bd9f8b18fbb101a ANA 12753753845 NULL 12753753845 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR APRESENTADO A MAIOR 1705
Glosa Min 2018-10-03 00:00:00.000000 1084117 15f461c0ca379f375bd9f8b18fbb101a ANA 12753753845 NULL 12753753845 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.8100 NULL VALOR APRESENTADO A MAIOR 1705
Glosa Min 2018-10-03 00:00:00.000000 1084117 15f461c0ca379f375bd9f8b18fbb101a ANA 12753753845 NULL 12753753845 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1771 NULL VALOR APRESENTADO A MAIOR 1705
Glosa Min 2018-10-03 00:00:00.000000 1084117 15f461c0ca379f375bd9f8b18fbb101a ANA 12753753845 NULL 12753753845 55279 TRAMADOL 50 MG 1 ML SI IM IV AP 0.0000 4.1900 NULL COBRANCA DE MEDICAMENTO INCOMPATIVEL COM O RELATORIO TECNICO 2112
Glosa Min 2018-10-03 00:00:00.000000 1084117 15f461c0ca379f375bd9f8b18fbb101a ANA 12753753845 NULL 12753753845 55279 TRAMADOL 50 MG 1 ML SI IM IV AP 0.0000 4.1900 NULL COBRANCA DE MEDICAMENTO INCOMPATIVEL COM O RELATORIO TECNICO 2112
Glosa Min 2018-10-03 00:00:00.000000 1084117 15f461c0ca379f375bd9f8b18fbb101a ANA 12753753845 NULL 12753753845 55279 TRAMADOL 50 MG 1 ML SI IM IV AP 0.0000 4.1900 NULL COBRANCA DE MEDICAMENTO INCOMPATIVEL COM O RELATORIO TECNICO 2112
Glosa Min 2018-10-03 00:00:00.000000 1084117 15f461c0ca379f375bd9f8b18fbb101a ANA 12753753845 NULL 12753753845 00657 CEFAZOLINA 1 GR + DIL. 10 ML PO IM IV FA 0.0000 8.1300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 15f461c0ca379f375bd9f8b18fbb101a ANA 12753753845 NULL 12753753845 00657 CEFAZOLINA 1 GR + DIL. 10 ML PO IM IV FA 0.0000 16.2600 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4072 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4072 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4072 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4072 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4072 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4072 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4072 NULL COBRANCA DE MEDICAMENTO EM QUANTIDADE INCOMPATIVEL COM A PERMANENCIA 2107
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4072 NULL COBRANCA DE MEDICAMENTO EM QUANTIDADE INCOMPATIVEL COM A PERMANENCIA 2107
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4072 NULL VALOR APRESENTADO A MAIOR 1705
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4072 NULL VALOR APRESENTADO A MAIOR 1705
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4072 NULL VALOR APRESENTADO A MAIOR 1705
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 02355 AMOXICILINA 1 G + CLAVULANATO 200 MG + DIL. 10 ML 0.0000 36.4667 NULL COBRANCA DE MEDICAMENTO EM QUANTIDADE INCOMPATIVEL COM A PERMANENCIA 2107
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 02355 AMOXICILINA 1 G + CLAVULANATO 200 MG + DIL. 10 ML 0.0000 36.4667 NULL COBRANCA DE MEDICAMENTO EM QUANTIDADE INCOMPATIVEL COM A PERMANENCIA 2107
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 02355 AMOXICILINA 1 G + CLAVULANATO 200 MG + DIL. 10 ML 0.0000 36.4667 NULL COBRANCA DE MEDICAMENTO EM QUANTIDADE INCOMPATIVEL COM A PERMANENCIA 2107
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 02355 AMOXICILINA 1 G + CLAVULANATO 200 MG + DIL. 10 ML 0.0000 36.4667 NULL COBRANCA DE MEDICAMENTO EM QUANTIDADE INCOMPATIVEL COM A PERMANENCIA 2107
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 02355 AMOXICILINA 1 G + CLAVULANATO 200 MG + DIL. 10 ML 0.0000 36.4667 NULL COBRANCA DE MEDICAMENTO EM QUANTIDADE INCOMPATIVEL COM A PERMANENCIA 2107
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00090 SERINGA DESC 20 ML UN 0.0000 0.5367 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00090 SERINGA DESC 20 ML UN 0.0000 0.5367 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00091 SERINGA DESC 01 ML (INSULINA) UN 0.0000 0.6100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 2e6b6f291f2df9beb1fbda6028678909 ANNA 12463693448 NULL 12463693448 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 2e6b6f291f2df9beb1fbda6028678909 ANNA 12463693448 NULL 12463693448 29020166 Nebulização Simples com Broncodilatador 0.0000 4.6800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 2e6b6f291f2df9beb1fbda6028678909 ANNA 12463693448 NULL 12463693448 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 11325 EQUIPO MACRO-GOTAS FLEXIVEL C/ INJETOR LATERAL UN 0.0000 1.5900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00124 LUVA CIRURGICA UN 0.0000 1.4478 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00124 LUVA CIRURGICA UN 0.0000 1.4478 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00124 LUVA CIRURGICA UN 0.0000 1.4478 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00124 LUVA CIRURGICA UN 0.0000 1.4478 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00124 LUVA CIRURGICA UN 0.0000 1.4478 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6871 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 35382 COMPRESSAS DE GASES 7.5 X7,5 (11 FIOS ESTERIL) UN 0.0000 0.3000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 35382 COMPRESSAS DE GASES 7.5 X7,5 (11 FIOS ESTERIL) UN 0.0000 0.6000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00487 RANITIDINA 25 MG/ML 2 ML SI IM IV AP 0.0000 0.9300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.4000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.4000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.4000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.4000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1776 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1776 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1776 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 51649 ALCOOL ETILICO 70 % ST TP ML 0.0000 0.0300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00090 SERINGA DESC 20 ML UN 0.0000 0.5350 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00090 SERINGA DESC 20 ML UN 0.0000 0.5375 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00090 SERINGA DESC 20 ML UN 0.0000 0.5375 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00090 SERINGA DESC 20 ML UN 0.0000 0.5375 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00090 SERINGA DESC 20 ML UN 0.0000 0.5375 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00090 SERINGA DESC 20 ML UN 0.0000 0.5375 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00090 SERINGA DESC 20 ML UN 0.0000 0.5375 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00090 SERINGA DESC 20 ML UN 0.0000 0.5375 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00090 SERINGA DESC 20 ML UN 0.0000 0.5375 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00090 SERINGA DESC 20 ML UN 0.0000 0.5375 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00090 SERINGA DESC 20 ML UN 0.0000 0.5375 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00090 SERINGA DESC 20 ML UN 0.0000 0.5375 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00090 SERINGA DESC 20 ML UN 0.0000 0.5375 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 09586cdd4dbbc5a8f142ad1eff19fbe6 VALDECI 12697562440 NULL 12697562440 25040014 Fisioterapia Respiratória - em Doente Clínico Internado 0.0000 15.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.8074 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.8074 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.8074 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1775 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1775 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1775 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1775 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1775 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1775 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1775 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1775 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 51584 ESPARADRAPO MICROPORE 0.0000 0.3800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 51584 ESPARADRAPO MICROPORE 0.0000 0.3800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 51584 ESPARADRAPO MICROPORE 0.0000 0.3800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 00090 SERINGA DESC 20 ML UN 0.0000 0.5375 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 00090 SERINGA DESC 20 ML UN 0.0000 0.5375 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 00090 SERINGA DESC 20 ML UN 0.0000 0.5375 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 00090 SERINGA DESC 20 ML UN 0.0000 0.5375 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 00380 SALBUTAMOL 100 MCG SY VO DS NULL 0.0000 NULL OPME INVALIDO 2201
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 20691 HIDROCORTISONA 100 MG PO IM IV FA 0.0000 2.8300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 26981 SORO FISIOLOGICO 0,9% 10 ML SI IV AP 0.0000 0.1400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 26981 SORO FISIOLOGICO 0,9% 10 ML SI IV AP 0.0000 0.1400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 26981 SORO FISIOLOGICO 0,9% 10 ML SI IV AP 0.0000 0.1400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 26981 SORO FISIOLOGICO 0,9% 10 ML SI IV AP 0.0000 0.4800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1780 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1765 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1765 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1765 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1765 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1765 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1765 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1765 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1765 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 00090 SERINGA DESC 20 ML UN 0.0000 0.5373 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 00098 ABOCATH N 14 A 22 UN 0.0000 3.7700 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 61e4786d45edfdbf19b77fb2c6ce6b9c REINALDO 12754482747 NULL 12754482747 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 61e4786d45edfdbf19b77fb2c6ce6b9c REINALDO 12754482747 NULL 12754482747 00172 SORO FISIOLOGICO 0,9% 500 ML SI IV BS 0.0000 4.7300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 61e4786d45edfdbf19b77fb2c6ce6b9c REINALDO 12754482747 NULL 12754482747 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 61e4786d45edfdbf19b77fb2c6ce6b9c REINALDO 12754482747 NULL 12754482747 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 61e4786d45edfdbf19b77fb2c6ce6b9c REINALDO 12754482747 NULL 12754482747 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.4000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 61e4786d45edfdbf19b77fb2c6ce6b9c REINALDO 12754482747 NULL 12754482747 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.4000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 61e4786d45edfdbf19b77fb2c6ce6b9c REINALDO 12754482747 NULL 12754482747 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1800 NULL VALOR APRESENTADO A MAIOR 1705
Glosa Min 2018-10-03 00:00:00.000000 1084117 61e4786d45edfdbf19b77fb2c6ce6b9c REINALDO 12754482747 NULL 12754482747 51649 ALCOOL ETILICO 70 % ST TP ML 0.0000 0.0300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 61e4786d45edfdbf19b77fb2c6ce6b9c REINALDO 12754482747 NULL 12754482747 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 61e4786d45edfdbf19b77fb2c6ce6b9c REINALDO 12754482747 NULL 12754482747 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 102001 DIARIA DE APARTAMENTO 0.0000 288.8880 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 102001 DIARIA DE APARTAMENTO 0.0000 288.8880 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4072 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4072 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4072 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4072 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4072 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4072 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4072 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 081fdadb830fb547e83c43fabdb88372 ELZA 12377335349 NULL 12377335349 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 081fdadb830fb547e83c43fabdb88372 ELZA 12377335349 NULL 12377335349 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 081fdadb830fb547e83c43fabdb88372 ELZA 12377335349 NULL 12377335349 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 081fdadb830fb547e83c43fabdb88372 ELZA 12377335349 NULL 12377335349 01611 CLORETO DE POTASSIO 600 MG CA VO UN 0.0000 0.4900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 081fdadb830fb547e83c43fabdb88372 ELZA 12377335349 NULL 12377335349 01611 CLORETO DE POTASSIO 600 MG CA VO UN 0.0000 0.4900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 081fdadb830fb547e83c43fabdb88372 ELZA 12377335349 NULL 12377335349 02246 HIDROCORTISONA 100 MG PO IM IV FA 0.0000 5.6700 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 081fdadb830fb547e83c43fabdb88372 ELZA 12377335349 NULL 12377335349 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 081fdadb830fb547e83c43fabdb88372 ELZA 12377335349 NULL 12377335349 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1800 NULL PAGO CONFORME RELATORIO DE AUDITORIA EXTERNA ― CONTA INICIAL 1717
Glosa Min 2018-10-03 00:00:00.000000 1084117 081fdadb830fb547e83c43fabdb88372 ELZA 12377335349 NULL 12377335349 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 081fdadb830fb547e83c43fabdb88372 ELZA 12377335349 NULL 12377335349 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1800 NULL PAGO CONFORME RELATORIO DE AUDITORIA EXTERNA ― CONTA INICIAL 1717
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6860 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6860 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6860 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6860 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 04073 TRAMADOL 50 MG 1 ML SI IM IV AP 0.0000 4.1900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 51379 SERINGA DESC 05 ML UN 0.0000 0.1900 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 51379 SERINGA DESC 05 ML UN 0.0000 0.1900 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 51379 SERINGA DESC 05 ML UN 0.0000 0.1900 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 51379 SERINGA DESC 05 ML UN 0.0000 0.1900 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 51379 SERINGA DESC 05 ML UN 0.0000 0.1900 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 345c226bfea274af1372d41b0305a6c8 ALTINO 12720257940 NULL 12720257940 25722 OMEPRAZOL 40 MG + DIL. 10 ML PO IV FA 0.0000 0.0000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 345c226bfea274af1372d41b0305a6c8 ALTINO 12720257940 NULL 12720257940 00128 LUVA DE PROCEDIMENTO UNIDADE UN 0.0000 0.2898 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 01003 FUROSEMIDA 40 MG CP VO UN 0.0000 0.2700 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 01137 SONDA URETRAL N 12 UN 0.0000 0.7600 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 00124 LUVA CIRURGICA UN 0.0000 1.4500 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 00124 LUVA CIRURGICA UN 0.0000 1.4500 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 00128 LUVA DE PROCEDIMENTO UNIDADE UN 0.0000 1.6700 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 00128 LUVA DE PROCEDIMENTO UNIDADE UN 0.0000 1.6700 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 00128 LUVA DE PROCEDIMENTO UNIDADE UN 0.0000 0.6700 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 00128 LUVA DE PROCEDIMENTO UNIDADE UN 0.0000 1.0000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 00090 SERINGA DESC 20 ML UN 0.0000 0.5400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 01652 TRAMADOL 50 MG CP VO UN 0.0000 1.9300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 01652 TRAMADOL 50 MG CP VO UN 0.0000 1.9300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 01652 TRAMADOL 50 MG CP VO UN 0.0000 1.9300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 00184 CLORETO DE POTASSIO 10% 10 ML SI IV AP 0.0000 0.5900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6875 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6875 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 35382 COMPRESSAS DE GASES 7.5 X7,5 (11 FIOS ESTERIL) UN 0.0000 0.3000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 35382 COMPRESSAS DE GASES 7.5 X7,5 (11 FIOS ESTERIL) UN 0.0000 0.3000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 51588 ESPARADRAPO MICROPORE 50 X 10 CM CM 0.0000 0.7700 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3fb5c891f31bb9efcb05395066127c52 ALAIDE 12636273441 NULL 12636273441 00487 RANITIDINA 25 MG/ML 2 ML SI IM IV AP 0.0000 0.9300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 610c198ec4c064687cf0524f147d3aed ROBERTO 12748814743 NULL 12748814743 16322 BENZILPENICILINA POTASSICA CRIST. 5.000.000 8.0700 8.0683 0.0017 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 610c198ec4c064687cf0524f147d3aed ROBERTO 12748814743 NULL 12748814743 16322 BENZILPENICILINA POTASSICA CRIST. 5.000.000 8.0700 8.0683 0.0017 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 610c198ec4c064687cf0524f147d3aed ROBERTO 12748814743 NULL 12748814743 16322 BENZILPENICILINA POTASSICA CRIST. 5.000.000 8.0700 8.0683 0.0017 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 610c198ec4c064687cf0524f147d3aed ROBERTO 12748814743 NULL 12748814743 16322 BENZILPENICILINA POTASSICA CRIST. 5.000.000 8.0700 8.0683 0.0017 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 610c198ec4c064687cf0524f147d3aed ROBERTO 12748814743 NULL 12748814743 16322 BENZILPENICILINA POTASSICA CRIST. 5.000.000 8.0700 8.0685 0.0017 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 03280 CLOREXIDINA 2 % ST TP ML 0.0500 0.0200 0.0300 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 51378 SERINGA DESC 03 ML UN 0.1500 0.0600 0.0900 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 51378 SERINGA DESC 03 ML UN 0.1500 0.0600 0.0900 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 51457 LIDOCAINA 2% S/ VASO SI PE SC ML 0.2300 0.0900 0.1400 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 03280 CLOREXIDINA 2 % ST TP ML 0.2700 0.1100 0.1600 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00127 LUVA DE PROCEDIMENTO UNIDADE UN 0.3300 0.1300 0.2000 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00127 LUVA DE PROCEDIMENTO UNIDADE UN 0.3300 0.1300 0.2000 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00127 LUVA DE PROCEDIMENTO UNIDADE UN 0.3300 0.1300 0.2000 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00127 LUVA DE PROCEDIMENTO UNIDADE UN 0.3300 0.1300 0.2000 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.4000 0.1600 0.2400 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.4000 0.1600 0.2400 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.4000 0.1600 0.2400 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.4000 0.1600 0.2400 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.4000 0.1600 0.2400 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.4000 0.1600 0.2400 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 51589 ESPARADRAPO 10 X 4.5 CM CM 0.4000 0.1600 0.2400 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00090 SERINGA DESC 20 ML UN 0.5400 0.2200 0.3200 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 19400 CIPROFLOXACINO 2 MG/ML 100 ML SI IV BS 80.1700 31.3000 48.8700 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 07802 PIPERACILINA 4 G + TAZOBACTAM 500 MG PO IV FA 83.4500 32.5900 50.8600 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 07802 PIPERACILINA 4 G + TAZOBACTAM 500 MG PO IV FA 83.4500 32.5900 50.8600 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 07802 PIPERACILINA 4 G + TAZOBACTAM 500 MG PO IV FA 83.4500 32.5900 50.8600 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 07802 PIPERACILINA 4 G + TAZOBACTAM 500 MG PO IV FA 83.4500 32.5900 50.8600 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00020010 Visita Hospitalar (Paciente Internado) 131.4000 51.3100 80.0900 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 201002 TAXA DE SALA PORTE 1 198.6200 77.5600 121.0600 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 54626 CATETER VENOSO CENTRAL DUPLO LUMEN 5FRX10 A 16CM 200.0000 78.1000 121.9000 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 01081197 e0b1f77dc9cff210f2fbead99c7ba4d4 MARCIO 12790052920 NULL 12790052920 53895 OMNIPAQUE (IOEXOL) 300 MG/IML SI IT IV VO ML NULL 0.0000 NULL OPME INVALIDO 2201
Glosa Min 2018-10-03 00:00:00.000000 1084117 16b1e9f62f247f02ad5cac910ee15b4e BERCHOLINA 12631612848 NULL 12631612848 04073 TRAMADOL 50 MG 1 ML SI IM IV AP 4.1900 4.0000 0.1900 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 16b1e9f62f247f02ad5cac910ee15b4e BERCHOLINA 12631612848 NULL 12631612848 04073 TRAMADOL 50 MG 1 ML SI IM IV AP 4.1900 4.0000 0.1900 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 16b1e9f62f247f02ad5cac910ee15b4e BERCHOLINA 12631612848 NULL 12631612848 04073 TRAMADOL 50 MG 1 ML SI IM IV AP 4.1900 3.9900 0.2000 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 16b1e9f62f247f02ad5cac910ee15b4e BERCHOLINA 12631612848 NULL 12631612848 22421 PIPERACILINA 2 G + TAZOBACTAM 250 MG 30 ML PO IV 55.3400 52.7400 2.6000 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 16b1e9f62f247f02ad5cac910ee15b4e BERCHOLINA 12631612848 NULL 12631612848 22421 PIPERACILINA 2 G + TAZOBACTAM 250 MG 30 ML PO IV 55.3400 52.7400 2.6000 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 16b1e9f62f247f02ad5cac910ee15b4e BERCHOLINA 12631612848 NULL 12631612848 22421 PIPERACILINA 2 G + TAZOBACTAM 250 MG 30 ML PO IV 55.3400 52.7400 2.6000 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 16b1e9f62f247f02ad5cac910ee15b4e BERCHOLINA 12631612848 NULL 12631612848 20080 LINEZOLIDA 2 MG/ML 300 ML SI IV BS 174.9800 166.7800 8.2000 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 16b1e9f62f247f02ad5cac910ee15b4e BERCHOLINA 12631612848 NULL 12631612848 20080 LINEZOLIDA 2 MG/ML 300 ML SI IV BS 174.9800 166.7800 8.2000 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 16b1e9f62f247f02ad5cac910ee15b4e BERCHOLINA 12631612848 NULL 12631612848 102001 DIARIA DE APARTAMENTO 2022.2100 1927.5200 94.6900 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 02720 BOLSA COLETORA (SISTEMA ABERTO) UN 1.2800 0.6400 0.6400 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 32204 CLORETO DE SODIO 0,9% 10 ML SI IV AP 0.9600 0.0000 0.9600 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 02720 BOLSA COLETORA (SISTEMA ABERTO) UN 1.2800 0.6400 0.6400 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 37761 ALCOOL ETILICO 70 % ST TP ML 0.0600 0.0300 0.0300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 02720 BOLSA COLETORA (SISTEMA ABERTO) UN 1.2800 0.6400 0.6400 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.3500 0.0000 0.3500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 28959 DERSANI LC TP ML 19.4000 14.5500 4.8500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 00485 AGUA BIDESTILADA 500 ML SI IM IV BS 6.4300 0.0000 6.4300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 d17b3c5ae418d82694895a326dee545a ODILIA 12670516743 NULL 12670516743 37761 ALCOOL ETILICO 70 % ST TP ML 0.0300 0.0200 0.0100 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 d17b3c5ae418d82694895a326dee545a ODILIA 12670516743 NULL 12670516743 37761 ALCOOL ETILICO 70 % ST TP ML 0.0300 0.0200 0.0100 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 37761 ALCOOL ETILICO 70 % ST TP ML 0.0600 0.0200 0.0400 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 00817 ALGODAO HIDROFILO BOLINHA UN 0.5100 0.1300 0.3800 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 01724 ATADURA CREPOM 10 CM UN 0.7900 0.0000 0.7900 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 32891 EQUIPO POLIFIX 2ş VIAS UN 5.1000 2.5500 2.5500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 32891 EQUIPO POLIFIX 2ş VIAS UN 5.1000 0.0000 5.1000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 08648 ESPARADRAPO 10 X 4.5 CM CM 0.4000 0.2000 0.2000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00485 AGUA BIDESTILADA 500 ML SI IM IV BS 6.4300 0.0000 6.4300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 02720 BOLSA COLETORA (SISTEMA ABERTO) UN 1.2800 0.6400 0.6400 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 02720 BOLSA COLETORA (SISTEMA ABERTO) UN 1.2800 0.6400 0.6400 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 08648 ESPARADRAPO 10 X 4.5 CM CM 0.4000 0.2000 0.2000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 22748 LIDOCAINA 2% GE TP OU GR 2.5900 1.3000 1.2900 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 02720 BOLSA COLETORA (SISTEMA ABERTO) UN 1.2800 0.6400 0.6400 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 02720 BOLSA COLETORA (SISTEMA ABERTO) UN 1.2800 0.3200 0.9600 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00817 ALGODAO HIDROFILO BOLINHA UN 0.5100 0.2600 0.2500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00817 ALGODAO HIDROFILO BOLINHA UN 0.5100 0.2600 0.2500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00817 ALGODAO HIDROFILO BOLINHA UN 0.5100 0.2600 0.2500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 33219 LUVA DE PROCEDIMENTO UNIDADE UN 0.3300 0.0000 0.3300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 37761 ALCOOL ETILICO 70 % ST TP ML 0.0600 0.0300 0.0300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 37761 ALCOOL ETILICO 70 % ST TP ML 0.0600 0.0300 0.0300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 752c651cb4fd049e19c685f87fbe8bdc EDUARDO 12765990646 NULL 12765990646 37761 ALCOOL ETILICO 70 % ST TP ML 0.0300 0.0200 0.0100 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 752c651cb4fd049e19c685f87fbe8bdc EDUARDO 12765990646 NULL 12765990646 18457 REPARIL (ESCINA + DIETILAMONIO) GL TP GR 5.6300 1.8800 3.7500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 752c651cb4fd049e19c685f87fbe8bdc EDUARDO 12765990646 NULL 12765990646 00817 ALGODAO HIDROFILO BOLINHA UN 0.5100 0.1300 0.3800 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 752c651cb4fd049e19c685f87fbe8bdc EDUARDO 12765990646 NULL 12765990646 08435 EQUIPO P/ BOMBA DE INFUSAO ENTERAL / PARENT 40.5600 0.0000 40.5600 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 752c651cb4fd049e19c685f87fbe8bdc EDUARDO 12765990646 NULL 12765990646 37761 ALCOOL ETILICO 70 % ST TP ML 0.0600 0.0200 0.0400 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 752c651cb4fd049e19c685f87fbe8bdc EDUARDO 12765990646 NULL 12765990646 00817 ALGODAO HIDROFILO BOLINHA UN 0.2600 0.1300 0.1300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 02461 FENOTEROL 2 MG/ML 10 ML AE IN DS 2.5500 0.0000 2.5500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 345c226bfea274af1372d41b0305a6c8 ALTINO 12720257940 NULL 12720257940 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1000 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 345c226bfea274af1372d41b0305a6c8 ALTINO 12720257940 NULL 12720257940 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1000 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 345c226bfea274af1372d41b0305a6c8 ALTINO 12720257940 NULL 12720257940 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1000 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 345c226bfea274af1372d41b0305a6c8 ALTINO 12720257940 NULL 12720257940 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1000 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 345c226bfea274af1372d41b0305a6c8 ALTINO 12720257940 NULL 12720257940 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1000 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 345c226bfea274af1372d41b0305a6c8 ALTINO 12720257940 NULL 12720257940 07269 DIPIRONA 500 MG/ML 2 ML SI IV IM AP 0.6900 0.6860 0.0040 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 345c226bfea274af1372d41b0305a6c8 ALTINO 12720257940 NULL 12720257940 13404 OMEPRAZOL 40 MG + DIL. 10 ML PO IV FA 19.5800 19.5750 0.0050 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 345c226bfea274af1372d41b0305a6c8 ALTINO 12720257940 NULL 12720257940 13404 OMEPRAZOL 40 MG + DIL. 10 ML PO IV FA 19.5800 19.5750 0.0050 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 31d18d6607d9e742c53e748d6a55d740 CARLOS 12557779343 NULL 12557779343 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1760 0.0040 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 0405a686318e3fc262f105ed4be24d95 CARMELITA 12687161644 NULL 12687161644 07269 DIPIRONA 500 MG/ML 2 ML SI IV IM AP 0.6900 0.6875 0.0025 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 0405a686318e3fc262f105ed4be24d95 CARMELITA 12687161644 NULL 12687161644 07269 DIPIRONA 500 MG/ML 2 ML SI IV IM AP 0.6900 0.6875 0.0025 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 0405a686318e3fc262f105ed4be24d95 CARMELITA 12687161644 NULL 12687161644 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8077 0.0023 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 0405a686318e3fc262f105ed4be24d95 CARMELITA 12687161644 NULL 12687161644 07269 DIPIRONA 500 MG/ML 2 ML SI IV IM AP 0.6900 0.6873 0.0027 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 0405a686318e3fc262f105ed4be24d95 CARMELITA 12687161644 NULL 12687161644 07269 DIPIRONA 500 MG/ML 2 ML SI IV IM AP 0.6900 0.6873 0.0027 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 0405a686318e3fc262f105ed4be24d95 CARMELITA 12687161644 NULL 12687161644 19160 SERINGA DESC 20 ML UN 0.5400 0.5367 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 0405a686318e3fc262f105ed4be24d95 CARMELITA 12687161644 NULL 12687161644 19160 SERINGA DESC 20 ML UN 0.5400 0.5367 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 0405a686318e3fc262f105ed4be24d95 CARMELITA 12687161644 NULL 12687161644 19160 SERINGA DESC 20 ML UN 0.5400 0.5367 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 0405a686318e3fc262f105ed4be24d95 CARMELITA 12687161644 NULL 12687161644 19160 SERINGA DESC 20 ML UN 0.5400 0.5367 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 ea6abb4182a48f0934f3e9eb5affa056 DILVA 12697455440 NULL 12697455440 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1750 0.0050 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 500e4b8f04552b423f9db8f81073659f FIDELIS 12763450340 NULL 12763450340 07269 DIPIRONA 500 MG/ML 2 ML SI IV IM AP 2.0600 2.0500 0.0000 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 500e4b8f04552b423f9db8f81073659f FIDELIS 12763450340 NULL 12763450340 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1760 0.0040 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 27600 ONDANSETRONA 2 MG/ML 4 ML SI IM IV AP 13.5300 0.0000 13.5300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 27600 ONDANSETRONA 2 MG/ML 4 ML SI IM IV AP 13.5300 0.0000 13.5300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8075 0.0025 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 33219 LUVA DE PROCEDIMENTO UNIDADE UN 0.6700 0.6680 0.0020 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 08664 ESPARADRAPO MICROPORE 50 X 10 CM CM 0.2600 0.2561 0.0039 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 25739 ELETRODO DESCARTAVEL (UTI) UN 4.6100 0.0000 4.6100 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 00817 ALGODAO HIDROFILO BOLINHA UN 0.5100 0.0000 0.5100 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 08648 ESPARADRAPO 10 X 4.5 CM CM 0.4000 0.0000 0.4000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 08648 ESPARADRAPO 10 X 4.5 CM CM 0.4000 0.0000 0.4000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 31d18d6607d9e742c53e748d6a55d740 CARLOS 12557779343 NULL 12557779343 11193 CLOREXIDINA 2 % ST TP ML 0.8000 0.2700 0.5300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 33219 LUVA DE PROCEDIMENTO UNIDADE UN 1.0000 0.6700 0.3300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 07269 DIPIRONA 500 MG/ML 2 ML SI IV IM AP 0.6900 0.0000 0.6900 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 33219 LUVA DE PROCEDIMENTO UNIDADE UN 1.0000 0.6700 0.3300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 33219 LUVA DE PROCEDIMENTO UNIDADE UN 1.0000 0.6700 0.3300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 33219 LUVA DE PROCEDIMENTO UNIDADE UN 1.0000 0.6700 0.3300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 33219 LUVA DE PROCEDIMENTO UNIDADE UN 1.0000 0.6700 0.3300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 02461 FENOTEROL 2 MG/ML 10 ML AE IN DS 0.4300 0.0000 0.4300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 30376 BROMETO DE IPRATROPIO 0,25MG/ML SL IN GT 2.0000 0.0000 2.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 02461 FENOTEROL 2 MG/ML 10 ML AE IN DS 0.2600 0.0000 0.2600 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 30376 BROMETO DE IPRATROPIO 0,25MG/ML SL IN GT 0.0200 0.0000 0.0200 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 30376 BROMETO DE IPRATROPIO 0,25MG/ML SL IN GT 1.8000 0.0000 1.8000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 02461 FENOTEROL 2 MG/ML 10 ML AE IN DS 1.2800 0.0000 1.2800 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 d4089ccef13567fd45b16fb0b60685fa VERA 12656425943 NULL 12656425943 33219 LUVA DE PROCEDIMENTO UNIDADE UN 1.6700 0.6700 1.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 33219 LUVA DE PROCEDIMENTO UNIDADE UN 1.3300 0.6700 0.6600 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 00817 ALGODAO HIDROFILO BOLINHA UN 0.5100 0.2600 0.2500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cd2840524be5a3f1d0939f241e24f32b MARIA 12705908340 NULL 12705908340 37761 ALCOOL ETILICO 70 % ST TP ML 0.0300 0.0200 0.0100 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cd2840524be5a3f1d0939f241e24f32b MARIA 12705908340 NULL 12705908340 37761 ALCOOL ETILICO 70 % ST TP ML 0.0300 0.0200 0.0100 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cd2840524be5a3f1d0939f241e24f32b MARIA 12705908340 NULL 12705908340 02461 FENOTEROL 2 MG/ML 10 ML AE IN DS 1.2800 0.0000 1.2800 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12603877940 NULL 12603877940 55018 ALGINATO DE CALCIO EM HIDROGEL GL TP GR 20.7000 13.8000 6.9000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12603877940 NULL 12603877940 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.6200 0.5100 0.1100 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12603877940 NULL 12603877940 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 10.2200 0.0000 10.2200 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12603877940 NULL 12603877940 07269 DIPIRONA 500 MG/ML 2 ML SI IV IM AP 2.7500 2.0600 0.6900 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12603877940 NULL 12603877940 33227 LUVA CIRURGICA PAR UN 11.5800 5.7900 5.7900 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12603877940 NULL 12603877940 00817 ALGODAO HIDROFILO BOLINHA UN 0.2600 0.1300 0.1300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12603877940 NULL 12603877940 37761 ALCOOL ETILICO 70 % ST TP ML 0.0300 0.0200 0.0100 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12603877940 NULL 12603877940 33227 LUVA CIRURGICA PAR UN 8.6900 7.2400 1.4500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12603877940 NULL 12603877940 00817 ALGODAO HIDROFILO BOLINHA UN 0.2600 0.1300 0.1300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00728 ESPIRONOLACTONA 25 MG CP VO UN 0.4800 0.0000 0.4800 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 31445 OMEPRAZOL 20 MG CA VO UN 0.4500 0.0000 0.4500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 19151 SERINGA DESC 10 ML UN 0.3300 0.0000 0.3300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 32204 CLORETO DE SODIO 0,9% 10 ML SI IV AP 2.4000 0.0000 2.4000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 30376 BROMETO DE IPRATROPIO 0,25MG/ML SL IN GT 3.2200 0.0000 3.2200 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 2b1cf1609fc72fb2a4e096bde8c345c1 JOAQUIM 12697596547 NULL 12697596547 25040014 ASSISTENCIA FISIATRICA RESPIRATORIA 0.0000 10.0600 NULL ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 3fb5c891f31bb9efcb05395066127c52 ALAIDE 12636273441 NULL 12636273441 00817 ALGODAO HIDROFILO BOLINHA UN 0.1300 0.1200 0.0000 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 a050ed50115d2a6dd0b15b99b39063da ARI 12676101147 NULL 12676101147 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1750 0.0050 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 a050ed50115d2a6dd0b15b99b39063da ARI 12676101147 NULL 12676101147 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1750 0.0050 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 a050ed50115d2a6dd0b15b99b39063da ARI 12676101147 NULL 12676101147 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1750 0.0050 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 a050ed50115d2a6dd0b15b99b39063da ARI 12676101147 NULL 12676101147 19160 SERINGA DESC 20 ML UN 0.5400 0.5367 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 a050ed50115d2a6dd0b15b99b39063da ARI 12676101147 NULL 12676101147 19160 SERINGA DESC 20 ML UN 0.5400 0.5367 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 a050ed50115d2a6dd0b15b99b39063da ARI 12676101147 NULL 12676101147 13404 OMEPRAZOL 40 MG + DIL. 10 ML PO IV FA 19.5800 19.5750 0.0050 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 a050ed50115d2a6dd0b15b99b39063da ARI 12676101147 NULL 12676101147 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4067 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 a050ed50115d2a6dd0b15b99b39063da ARI 12676101147 NULL 12676101147 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4067 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 a050ed50115d2a6dd0b15b99b39063da ARI 12676101147 NULL 12676101147 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4067 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 edffb7fef608512400078fdf75991573 CARLA 12728631049 NULL 12728631049 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8067 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 edffb7fef608512400078fdf75991573 CARLA 12728631049 NULL 12728631049 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8067 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 39df67956a358bf1eab89803158d25dd HELENA 12655863342 NULL 12655863342 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1750 0.0050 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 39df67956a358bf1eab89803158d25dd HELENA 12655863342 NULL 12655863342 33219 LUVA DE PROCEDIMENTO UNIDADE UN 0.6700 0.6659 0.0041 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 39df67956a358bf1eab89803158d25dd HELENA 12655863342 NULL 12655863342 33219 LUVA DE PROCEDIMENTO UNIDADE UN 1.6700 1.6647 0.0053 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 9d06dbe3a8516628c3a045963dfb9c42 INAN 12623574546 NULL 12623574546 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1757 0.0043 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 9d06dbe3a8516628c3a045963dfb9c42 INAN 12623574546 NULL 12623574546 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1757 0.0043 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 d4089ccef13567fd45b16fb0b60685fa VERA 12640482546 NULL 12640482546 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1754 0.0046 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 01081195 ad29f55cccce1ceaeb9c5f22ef02ddbc CELIA 12793164715 NULL 12793164715 00010014 CONSULTA EM CONSULTORIO MEDICO 0.0000 35.0000 NULL ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 cd8240dfed3b190f93e1f35f15f53916 WANDELCY 12756680448 NULL 12756680448 25040014 ASSISTENCIA FISIATRICA RESPIRATORIA 0.0000 0.0000 NULL ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 de1a8276d878171456d7fc8f6dcd2457 ABEL 12667085545 NULL 12667085545 07269 DIPIRONA 500 MG/ML 2 ML SI IV IM AP 0.6900 0.6800 0.0000 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 de1a8276d878171456d7fc8f6dcd2457 ABEL 12764206443 NULL 12764206443 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8067 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1770 0.0030 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1770 0.0030 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1770 0.0030 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1770 0.0030 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8072 0.0028 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8072 0.0028 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8072 0.0028 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 09733 ACETILCISTEINA 600MG PO VO SA 3.5000 3.4955 0.0045 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 09733 ACETILCISTEINA 600MG PO VO SA 3.5000 3.4955 0.0045 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 09733 ACETILCISTEINA 600MG PO VO SA 3.5000 3.4955 0.0045 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 09733 ACETILCISTEINA 600MG PO VO SA 3.5000 3.4955 0.0045 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 09733 ACETILCISTEINA 600MG PO VO SA 3.5000 3.4955 0.0045 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 08664 ESPARADRAPO MICROPORE 50 X 10 CM CM 0.2600 0.2561 0.0039 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 08664 ESPARADRAPO MICROPORE 50 X 10 CM CM 0.7700 0.7682 0.0018 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 08664 ESPARADRAPO MICROPORE 50 X 10 CM CM 0.7700 0.7682 0.0018 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 37761 ALCOOL ETILICO 70 % ST TP ML 0.0200 0.0150 0.0050 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 20672 SORO RINGER SIMPLES 500 ML SI IV BS 5.9400 5.9367 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 20672 SORO RINGER SIMPLES 500 ML SI IV BS 5.9400 5.9367 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 58661 ENCRISE (ARGIPRESSINA) 20 U/ML 1 ML SI SC 40.2400 40.2343 0.0057 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 22896 CEFUROXIMA 750 MG + DIL. 6 ML PO IM IV FA 26.1300 26.1271 0.0029 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 42358 FUROSEMIDA 10 MG/ML 2 ML SI IM IV AP 0.6000 0.5986 0.0014 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 42358 FUROSEMIDA 10 MG/ML 2 ML SI IM IV AP 0.6000 0.5986 0.0014 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4078 0.0022 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4078 0.0022 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4078 0.0022 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4078 0.0022 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4078 0.0022 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4078 0.0022 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4078 0.0022 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4078 0.0022 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 33227 LUVA CIRURGICA PAR UN 1.4500 1.4476 0.0024 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 33227 LUVA CIRURGICA PAR UN 1.4500 1.4476 0.0024 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 33227 LUVA CIRURGICA PAR UN 1.4500 1.4476 0.0024 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 33227 LUVA CIRURGICA PAR UN 1.4500 1.4476 0.0024 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 b288bbcfb9aecab51bcb0dba62ca0059 IVONETE 12743730847 NULL 12743730847 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4067 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 b288bbcfb9aecab51bcb0dba62ca0059 IVONETE 12743730847 NULL 12743730847 19160 SERINGA DESC 20 ML UN 0.5400 0.5367 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 b288bbcfb9aecab51bcb0dba62ca0059 IVONETE 12743730847 NULL 12743730847 19160 SERINGA DESC 20 ML UN 0.5400 0.5367 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 b288bbcfb9aecab51bcb0dba62ca0059 IVONETE 12743730847 NULL 12743730847 19160 SERINGA DESC 20 ML UN 0.5400 0.5367 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.3800 0.3800 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 53660 EQUIPO MACRO-GOTAS FLEXIVEL C/ INJETOR LATE 1.5900 0.0000 1.5900 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 33227 LUVA CIRURGICA PAR UN 1.4500 1.4500 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 33227 LUVA CIRURGICA PAR UN 1.4500 1.4500 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 08664 ESPARADRAPO MICROPORE 50 X 10 CM CM 0.7700 0.7700 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4080 0.0020 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4084 0.0016 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4084 0.0016 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4084 0.0016 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4084 0.0016 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1036 -0.0036 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1036 -0.0036 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 06343 CLINDAMICINA 600 MG 4 ML SI IM IV AP 13.0800 13.0800 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 00035 ABOCATH (CATETER INTRAVENOSO) N. 14 A 22 UN 3.7700 3.7700 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 670141098c0309ac9be3db204bdc12cf LEOSINA 12706525442 NULL 12706525442 33219 LUVA DE PROCEDIMENTO UNIDADE UN 1.0000 0.9900 0.0000 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 670141098c0309ac9be3db204bdc12cf LEOSINA 12706525442 NULL 12706525442 05444 CLORETO DE POTASSIO 15% 10 ML SI IV AP 1.0300 1.0200 0.0000 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 19160 SERINGA DESC 20 ML UN 0.5400 0.5384 0.0016 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 00817 ALGODAO HIDROFILO BOLINHA UN 0.1300 0.1300 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 02461 FENOTEROL 2 MG/ML 10 ML AE IN DS 0.3400 0.0000 0.3400 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 32204 CLORETO DE SODIO 0,9% 10 ML SI IV AP 0.4800 0.4800 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8067 0.0033 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8067 0.0033 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8067 0.0033 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 32204 CLORETO DE SODIO 0,9% 10 ML SI IV AP 0.4800 0.0000 0.4800 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 32204 CLORETO DE SODIO 0,9% 10 ML SI IV AP 0.9600 0.9600 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 05975 COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER 0.3000 0.0000 0.3000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.4000 0.0000 0.4000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.4000 0.0000 0.4000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.0000 0.8100 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 08648 ESPARADRAPO 10 X 4.5 CM CM 0.4000 0.0000 0.4000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 32204 CLORETO DE SODIO 0,9% 10 ML SI IV AP 0.4800 0.0000 0.4800 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 32204 CLORETO DE SODIO 0,9% 10 ML SI IV AP 0.4800 0.0000 0.4800 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 32204 CLORETO DE SODIO 0,9% 10 ML SI IV AP 0.9600 0.9600 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e715e2ae28a6229c8609756d3298bf52 MARIA 12734221144 NULL 12734221144 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1750 0.0050 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e715e2ae28a6229c8609756d3298bf52 MARIA 12734221144 NULL 12734221144 30511 CEFALOTINA 1 G FA + DIL. 10 ML FA 4.6600 4.6550 0.0050 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e715e2ae28a6229c8609756d3298bf52 MARIA 12734221144 NULL 12734221144 30511 CEFALOTINA 1 G FA + DIL. 10 ML FA 4.6600 4.6550 0.0050 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 29661 NOREPINEFRINA 2 MG/ML 4 ML SI IV AP 37.9900 37.9800 0.0000 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 05975 COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER 0.3000 0.3836 -0.0836 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 05975 COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER 0.3000 0.0000 0.3000 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 19119 SERINGA DESC 01 ML (INSULINA) UN 0.3100 0.3050 0.0050 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 19119 SERINGA DESC 01 ML (INSULINA) UN 0.3100 0.3050 0.0050 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 33537 PIPERACILINA 2 G + TAZOBACTAM 250 MG 30 ML 55.3400 55.3375 0.0025 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 33537 PIPERACILINA 2 G + TAZOBACTAM 250 MG 30 ML 55.3400 55.3375 0.0025 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 33537 PIPERACILINA 2 G + TAZOBACTAM 250 MG 30 ML 55.3400 55.3375 0.0025 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 33537 PIPERACILINA 2 G + TAZOBACTAM 250 MG 30 ML 55.3400 55.3375 0.0025 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 42358 FUROSEMIDA 10 MG/ML 2 ML SI IM IV AP 1.2000 1.1964 0.0036 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4061 0.0039 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4061 0.0039 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 33227 LUVA CIRURGICA PAR UN 1.4500 1.4477 0.0023 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 33227 LUVA CIRURGICA PAR UN 1.4500 1.4477 0.0023 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 08664 ESPARADRAPO MICROPORE 50 X 10 CM CM 0.7700 0.7650 0.0050 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 53660 EQUIPO MACRO-GOTAS FLEXIVEL C/ INJETOR LATE 1.5900 0.0000 1.5900 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 22748 LIDOCAINA 2% GE TP OU GR 2.5900 1.3000 1.2900 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 08664 ESPARADRAPO MICROPORE 50 X 10 CM CM 0.7700 0.7650 0.0050 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 19135 SERINGA DESC 03 ML UN 0.1500 0.0000 0.1500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 19151 SERINGA DESC 10 ML UN 0.6700 0.6657 0.0043 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 19151 SERINGA DESC 10 ML UN 0.6700 0.6657 0.0043 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1772 0.0028 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1772 0.0028 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1772 0.0028 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 08664 ESPARADRAPO MICROPORE 50 X 10 CM CM 0.7700 0.7670 0.0030 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 08664 ESPARADRAPO MICROPORE 50 X 10 CM CM 0.7700 0.7670 0.0030 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cd2840524be5a3f1d0939f241e24f32b MARIA 12705908340 NULL 12705908340 32204 CLORETO DE SODIO 0,9% 10 ML SI IV AP 0.4800 0.0000 0.4800 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cd2840524be5a3f1d0939f241e24f32b MARIA 12705908340 NULL 12705908340 30376 BROMETO DE IPRATROPIO 0,25MG/ML SL IN GT 0.4000 0.0000 0.4000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cd2840524be5a3f1d0939f241e24f32b MARIA 12705908340 NULL 12705908340 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1764 0.0036 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cd2840524be5a3f1d0939f241e24f32b MARIA 12705908340 NULL 12705908340 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1764 0.0036 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cd2840524be5a3f1d0939f241e24f32b MARIA 12705908340 NULL 12705908340 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1764 0.0036 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cd2840524be5a3f1d0939f241e24f32b MARIA 12705908340 NULL 12705908340 02461 FENOTEROL 2 MG/ML 10 ML AE IN DS 0.4300 0.0000 0.4300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1766 0.0034 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1766 0.0034 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1766 0.0034 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1766 0.0034 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1766 0.0034 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1766 0.0034 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8077 0.0023 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 8a5ecfde671848d05ac757e0112e689c TEREZINHA 12700337042 NULL 12700337042 10626 GLICOSE 50% 10 ML SI IV AP 2.7400 2.7350 0.0050 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 8a5ecfde671848d05ac757e0112e689c TEREZINHA 12700337042 NULL 12700337042 10626 GLICOSE 50% 10 ML SI IV AP 2.7400 2.7350 0.0050 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 8a5ecfde671848d05ac757e0112e689c TEREZINHA 12700337042 NULL 12700337042 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4064 0.0036 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 8a5ecfde671848d05ac757e0112e689c TEREZINHA 12700337042 NULL 12700337042 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4071 0.0029 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 8a5ecfde671848d05ac757e0112e689c TEREZINHA 12700337042 NULL 12700337042 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4071 0.0029 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 8a5ecfde671848d05ac757e0112e689c TEREZINHA 12700337042 NULL 12700337042 19160 SERINGA DESC 20 ML UN 0.5400 0.5376 0.0024 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 8a5ecfde671848d05ac757e0112e689c TEREZINHA 12700337042 NULL 12700337042 19160 SERINGA DESC 20 ML UN 0.5400 0.5376 0.0024 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 8a5ecfde671848d05ac757e0112e689c TEREZINHA 12700337042 NULL 12700337042 19160 SERINGA DESC 20 ML UN 0.5400 0.5376 0.0024 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 70cf23c63f890f0b61da2542c3e13a09 TIAGO 12741864645 NULL 12741864645 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1762 0.0038 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 70cf23c63f890f0b61da2542c3e13a09 TIAGO 12741864645 NULL 12741864645 19160 SERINGA DESC 20 ML UN 0.5400 0.5367 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 70cf23c63f890f0b61da2542c3e13a09 TIAGO 12741864645 NULL 12741864645 19160 SERINGA DESC 20 ML UN 0.5400 0.5367 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 70cf23c63f890f0b61da2542c3e13a09 TIAGO 12741864645 NULL 12741864645 19160 SERINGA DESC 20 ML UN 0.5400 0.5367 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 70cf23c63f890f0b61da2542c3e13a09 TIAGO 12741864645 NULL 12741864645 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4075 0.0025 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 70cf23c63f890f0b61da2542c3e13a09 TIAGO 12741864645 NULL 12741864645 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4075 0.0025 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 32204 CLORETO DE SODIO 0,9% 10 ML SI IV AP 0.4800 0.0000 0.4800 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 33227 LUVA CIRURGICA PAR UN 1.4500 1.4476 0.0024 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 33227 LUVA CIRURGICA PAR UN 1.4500 1.4476 0.0024 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 0111beed375944f60c7ad4a7fd4874f8 WALDIR 12746025744 NULL 12746025744 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 1.6200 1.6147 0.0053 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 0111beed375944f60c7ad4a7fd4874f8 WALDIR 12746025744 NULL 12746025744 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 1.6200 1.6147 0.0053 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 0111beed375944f60c7ad4a7fd4874f8 WALDIR 12746025744 NULL 12746025744 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4076 0.0024 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 0111beed375944f60c7ad4a7fd4874f8 WALDIR 12746025744 NULL 12746025744 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4076 0.0024 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 0111beed375944f60c7ad4a7fd4874f8 WALDIR 12746025744 NULL 12746025744 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4076 0.0024 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 0111beed375944f60c7ad4a7fd4874f8 WALDIR 12746025744 NULL 12746025744 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4076 0.0024 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 0111beed375944f60c7ad4a7fd4874f8 WALDIR 12746025744 NULL 12746025744 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4076 0.0024 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 0111beed375944f60c7ad4a7fd4874f8 WALDIR 12746025744 NULL 12746025744 19160 SERINGA DESC 20 ML UN 0.5400 0.5379 0.0021 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 0111beed375944f60c7ad4a7fd4874f8 WALDIR 12746025744 NULL 12746025744 19160 SERINGA DESC 20 ML UN 0.5400 0.5379 0.0021 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 0111beed375944f60c7ad4a7fd4874f8 WALDIR 12746025744 NULL 12746025744 19160 SERINGA DESC 20 ML UN 0.5400 0.5379 0.0021 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 00817 ALGODAO HIDROFILO BOLINHA UN 0.1300 0.0000 0.1300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 37761 ALCOOL ETILICO 70 % ST TP ML 0.0300 0.0000 0.0300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 00817 ALGODAO HIDROFILO BOLINHA UN 0.5100 0.0000 0.5100 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 37761 ALCOOL ETILICO 70 % ST TP ML 0.0300 0.0000 0.0300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 52353 ABAIXADOR DE LINGUA UN 0.0500 0.0267 0.0233 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 37761 ALCOOL ETILICO 70 % ST TP ML 0.0300 0.0000 0.0300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 37761 ALCOOL ETILICO 70 % ST TP ML 0.0600 0.0300 0.0300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 00817 ALGODAO HIDROFILO BOLINHA UN 0.5100 0.2600 0.2500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 27596 TIRA TESTE PARA GLICOSE UN 1.0400 1.0400 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 27596 TIRA TESTE PARA GLICOSE UN 1.0400 1.0400 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 27596 TIRA TESTE PARA GLICOSE UN 1.0400 1.0400 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 05975 COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER 0.3000 0.0000 0.3000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12662414945 NULL 12662414945 19160 SERINGA DESC 20 ML UN 0.5400 0.5365 0.0035 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12662414945 NULL 12662414945 19160 SERINGA DESC 20 ML UN 0.5400 0.5367 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12662414945 NULL 12662414945 19160 SERINGA DESC 20 ML UN 0.5400 0.5367 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12662414945 NULL 12662414945 19160 SERINGA DESC 20 ML UN 0.5400 0.5367 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12662414945 NULL 12662414945 13404 OMEPRAZOL 40 MG + DIL. 10 ML PO IV FA 19.5800 19.5750 0.0050 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12662414945 NULL 12662414945 19445 CLORETO DE POTASSIO 600 MG CA VO UN 0.4900 0.4867 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12662414945 NULL 12662414945 19445 CLORETO DE POTASSIO 600 MG CA VO UN 0.4900 0.4867 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12662414945 NULL 12662414945 19445 CLORETO DE POTASSIO 600 MG CA VO UN 0.4900 0.4867 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12662414945 NULL 12662414945 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4071 0.0029 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 05975 COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER 0.3000 0.3000 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 05975 COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER 0.3000 0.3000 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 33227 LUVA CIRURGICA PAR UN 1.4500 1.4476 0.0024 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1770 0.0030 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1770 0.0030 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1770 0.0030 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1770 0.0030 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1770 0.0030 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1770 0.0030 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 000441 TAXA DE DELEUCOTIZAÇÃO NULL 0.0000 NULL OPME INVALIDO 2201
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 11700 EQUIPO P/ BOMBA DE INFUSAO ENTERAL / PARENTERAL NULL 0.0000 NULL OPME INVALIDO 2201
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 00124 LUVA CIRURGICA UN NULL 0.0000 NULL OPME INVALIDO 2201
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 00172 SORO FISIOLOGICO 0,9% 500 ML SI IV BS NULL 0.0000 NULL OPME INVALIDO 2201
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 00172 SORO FISIOLOGICO 0,9% 500 ML SI IV BS NULL 0.0000 NULL OPME INVALIDO 2201
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 00172 SORO FISIOLOGICO 0,9% 500 ML SI IV BS NULL 0.0000 NULL OPME INVALIDO 2201
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 07269 DIPIRONA 500 MG/ML 2 ML SI IV IM AP 0.6900 0.0000 0.6900 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 32204 CLORETO DE SODIO 0,9% 10 ML SI IV AP 0.4800 0.0000 0.4800 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 32204 CLORETO DE SODIO 0,9% 10 ML SI IV AP 0.9600 0.4800 0.4800 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.2120 -0.1120 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.2120 -0.1120 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.2120 -0.1120 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.2120 -0.1120 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.2120 -0.1120 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1060 -0.0060 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1060 -0.0060 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1060 -0.0060 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1060 -0.0060 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1060 -0.0060 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1060 -0.0060 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1060 -0.0060 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1060 -0.0060 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1060 -0.0060 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1060 -0.0060 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 34827 TIORFAN (RACECADOTRILA) 100 MG CA VO UN 3.2000 6.4000 -3.2000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 19160 SERINGA DESC 20 ML UN 0.5400 0.5374 0.0026 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 07587 DRAMIN B6 DL (DIMENIDRINATO + PIRIDOXINA + 11.0637 13.2805 -11.0705 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 07587 DRAMIN B6 DL (DIMENIDRINATO + PIRIDOXINA + 11.0637 13.2805 -11.0705 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 31585 RANITIDINA 25 MG/ML 2 ML SI IV IM AP 0.9300 0.9334 -0.0034 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 19151 SERINGA DESC 10 ML UN 0.6634 1.0003 -0.6703 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 19151 SERINGA DESC 10 ML UN 0.6634 1.0003 -0.6703 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 19151 SERINGA DESC 10 ML UN 0.3300 0.6669 -0.3369 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 19151 SERINGA DESC 10 ML UN 0.3300 0.6669 -0.3369 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 19151 SERINGA DESC 10 ML UN 0.3300 0.6669 -0.3369 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 13935 METAMUCIL (PLANTAGO OVATA) 5,85 G PO VO E 4.9236 7.3907 -4.9307 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 11193 CLOREXIDINA 2 % ST TP ML 0.5300 0.5320 -0.0020 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 800720d33fe0defb6121e82dd216d044 JALMO 12786952647 NULL 12786952647 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 01611 CLORETO DE POTASSIO 600 MG CA VO UN 0.0000 0.0000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00182 SULFATO DE MAGNESIO 500 MG/ML 10 ML SI IM IV AP 0.0000 5.4300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 20010010 Eletrocardiograma - Ecg 0.0000 16.5300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 02246 HIDROCORTISONA 100 MG PO IM IV FA 0.0000 0.0000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 02246 HIDROCORTISONA 100 MG PO IM IV FA 0.0000 2.8300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 02246 HIDROCORTISONA 100 MG PO IM IV FA 0.0000 2.8300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 02246 HIDROCORTISONA 100 MG PO IM IV FA 0.0000 5.6700 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 02246 HIDROCORTISONA 100 MG PO IM IV FA 0.0000 5.6700 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 02246 HIDROCORTISONA 100 MG PO IM IV FA 0.0000 5.6689 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 02249 PREDNISONA 20 MG CP VO UN 0.0000 0.0000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 25040014 Fisioterapia Respiratória - em Doente Clínico Internado 0.0000 45.2500 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 26981 SORO FISIOLOGICO 0,9% 10 ML SI IV AP 0.0000 0.0000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 26981 SORO FISIOLOGICO 0,9% 10 ML SI IV AP 0.0000 0.9600 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 26981 SORO FISIOLOGICO 0,9% 10 ML SI IV AP 0.0000 0.9600 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00613 CLINDAMICINA 600 MG 4 ML SI IM IV AP 0.0000 13.0800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00613 CLINDAMICINA 600 MG 4 ML SI IM IV AP 0.0000 13.0800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 07802 PIPERACILINA 4 G + TAZOBACTAM 500 MG PO IV FA 0.0000 83.4500 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 07802 PIPERACILINA 4 G + TAZOBACTAM 500 MG PO IV FA 0.0000 83.4500 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 07802 PIPERACILINA 4 G + TAZOBACTAM 500 MG PO IV FA 0.0000 83.4500 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00796 FLORATIL (SACCHAROMYCES BOULARDII) 200 MG PO VO 0.0000 4.4400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 08829 Bricanyl 0,5mg Inj. Ampola C/ 1ml 0.0000 3.5900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 08829 Bricanyl 0,5mg Inj. Ampola C/ 1ml 0.0000 3.5900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 09071 ACETILCISTEINA 600MG PO VO SA 0.0000 3.4950 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 09071 ACETILCISTEINA 600MG PO VO SA 0.0000 3.4950 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 09071 ACETILCISTEINA 600MG PO VO SA 0.0000 3.4950 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 09071 ACETILCISTEINA 600MG PO VO SA 0.0000 3.4950 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00124 LUVA CIRURGICA UN 0.0000 1.4475 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00124 LUVA CIRURGICA UN 0.0000 1.4475 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4062 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4062 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4062 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4062 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4062 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4062 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4062 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4062 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4062 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4062 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4062 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4062 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4062 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4062 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4062 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 6.8124 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 01584 NEOSTIGMINA 0,5 MG/ML 1 ML SI IM IV SC AP 0.0000 0.7667 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 01584 NEOSTIGMINA 0,5 MG/ML 1 ML SI IM IV SC AP 0.0000 0.7667 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 01584 NEOSTIGMINA 0,5 MG/ML 1 ML SI IM IV SC AP 0.0000 0.7667 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 24082 BROMOPRIDA 5 MG/ML 2 ML SI IM IV AP 0.0000 2.7300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 24082 BROMOPRIDA 5 MG/ML 2 ML SI IM IV AP 0.0000 2.7300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 24082 BROMOPRIDA 5 MG/ML 2 ML SI IM IV AP 0.0000 2.7300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 24082 BROMOPRIDA 5 MG/ML 2 ML SI IM IV AP 0.0000 2.7300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00090 SERINGA DESC 20 ML UN 0.0000 0.5400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4088 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4088 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4088 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4088 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4088 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1766 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1766 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1766 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00090 SERINGA DESC 20 ML UN 0.0000 0.5400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00090 SERINGA DESC 20 ML UN 0.0000 0.5387 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00090 SERINGA DESC 20 ML UN 0.0000 0.5400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00090 SERINGA DESC 20 ML UN 0.0000 0.5387 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00090 SERINGA DESC 20 ML UN 0.0000 0.5387 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00090 SERINGA DESC 20 ML UN 0.0000 0.5387 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00090 SERINGA DESC 20 ML UN 0.0000 0.5387 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00090 SERINGA DESC 20 ML UN 0.0000 0.5387 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00090 SERINGA DESC 20 ML UN 0.0000 0.5387 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00090 SERINGA DESC 20 ML UN 0.0000 0.5387 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00090 SERINGA DESC 20 ML UN 0.0000 0.5387 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00090 SERINGA DESC 20 ML UN 0.0000 0.5387 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00090 SERINGA DESC 20 ML UN 0.0000 0.5387 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 4c68006246c347121db1f06edf5e5051 MARIA 12734155245 NULL 12734155245 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 00124 LUVA CIRURGICA UN 0.0000 1.4470 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 00124 LUVA CIRURGICA UN 0.0000 1.4473 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 00125 LUVA CIRURGICA UN 0.0000 1.4473 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4068 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4074 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4074 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 01611 CLORETO DE POTASSIO 600 MG CA VO UN 0.0000 0.4867 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 01611 CLORETO DE POTASSIO 600 MG CA VO UN 0.0000 0.4867 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 25040014 Fisioterapia Respiratória - em Doente Clínico Internado 0.0000 10.0600 NULL EXAME NAO AUTORIZADO 2707
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.3075 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 00037 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1775 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.8089 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 51208 SORO RINGER SIMPLES 500 ML SI IV BS 0.0000 11.8700 NULL EXAME NAO AUTORIZADO 2707
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1775 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1775 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1775 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1775 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1775 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1775 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1775 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1775 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 00090 SERINGA DESC 20 ML UN 0.0000 0.5376 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 00124 LUVA CIRURGICA UN 0.0000 1.4476 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 00124 LUVA CIRURGICA UN 0.0000 1.4476 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 00124 LUVA CIRURGICA UN 0.0000 1.4476 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 25040014 Fisioterapia Respiratória - em Doente Clínico Internado 0.0000 10.0600 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 00091 SERINGA DESC 01 ML (INSULINA) UN 0.0000 0.3050 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 00091 SERINGA DESC 01 ML (INSULINA) UN 0.0000 0.3050 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 00091 SERINGA DESC 01 ML (INSULINA) UN 0.0000 0.3050 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 00124 LUVA CIRURGICA UN 0.0000 1.4482 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 00124 LUVA CIRURGICA UN 0.0000 1.4482 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 00124 LUVA CIRURGICA UN 0.0000 1.4482 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 00124 LUVA CIRURGICA UN 0.0000 1.4500 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 00124 LUVA CIRURGICA UN 0.0000 1.4482 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 00128 LUVA DE PROCEDIMENTO UNIDADE UN 0.0000 1.6700 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4094 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4094 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4094 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.4000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.4000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.4000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.4000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.4000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.4000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1752 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1752 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 51241 AGULHA 123X45 0.0000 0.1900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 51649 ALCOOL ETILICO 70 % ST TP ML 0.0000 0.0000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 52392 SONDA DE ASPIRAÇAO TRAQUEAL C/ VALVULA UN 0.0000 0.9352 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 52392 SONDA DE ASPIRAÇAO TRAQUEAL C/ VALVULA UN 0.0000 0.9400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 52392 SONDA DE ASPIRAÇAO TRAQUEAL C/ VALVULA UN 0.0000 0.9400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 52392 SONDA DE ASPIRAÇAO TRAQUEAL C/ VALVULA UN 0.0000 0.9352 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6876 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6874 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6874 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.3500 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 53945 ACIDO ASCORBICO 500 MG CP VO UN 0.0000 0.5900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00128 LUVA DE PROCEDIMENTO UNIDADE UN 0.0000 1.6700 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00128 LUVA DE PROCEDIMENTO UNIDADE UN 0.0000 1.6700 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 01496 FENITOINA 50 MG/ML 5 ML SI IM IV AP 0.0000 2.3400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 01496 FENITOINA 50 MG/ML 5 ML SI IM IV AP 0.0000 2.3400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 01584 NEOSTIGMINA 0,5 MG/ML 1 ML SI IM IV SC AP 0.0000 0.7662 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00169 SORO GLICOSADO 5% 500 ML SI IV BS 0.0000 3.6715 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00171 SORO FISIOLOGICO 0,9% 250 ML SI IV BS 0.0000 3.9400 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 24082 BROMOPRIDA 5 MG/ML 2 ML SI IM IV AP 0.0000 2.7300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 24082 BROMOPRIDA 5 MG/ML 2 ML SI IM IV AP 0.0000 2.7300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 26981 SORO FISIOLOGICO 0,9% 10 ML SI IV AP 0.0000 0.9600 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 26981 SORO FISIOLOGICO 0,9% 10 ML SI IV AP 0.0000 0.9600 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ea4ad2636c25d8e3dbb569ae62db71e7 IONE 12489788840 NULL 12489788840 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ea4ad2636c25d8e3dbb569ae62db71e7 IONE 12489788840 NULL 12489788840 00737 CEFTRIAXONA IV 1G + DIL. 10 ML PO IV FA 0.0000 27.0600 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 d17b3c5ae418d82694895a326dee545a ODILIA 12670516743 NULL 12670516743 102001 DIARIA DE APARTAMENTO 0.0000 288.8881 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 d17b3c5ae418d82694895a326dee545a ODILIA 12670516743 NULL 12670516743 102001 DIARIA DE APARTAMENTO 0.0000 288.8882 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 d17b3c5ae418d82694895a326dee545a ODILIA 12670516743 NULL 12670516743 102001 DIARIA DE APARTAMENTO 0.0000 288.8882 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 d17b3c5ae418d82694895a326dee545a ODILIA 12670516743 NULL 12670516743 102001 DIARIA DE APARTAMENTO 0.0000 288.8882 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 d17b3c5ae418d82694895a326dee545a ODILIA 12670516743 NULL 12670516743 00128 LUVA DE PROCEDIMENTO UNIDADE UN 0.0000 1.0000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 d17b3c5ae418d82694895a326dee545a ODILIA 12670516743 NULL 12670516743 02197 METAMUCIL (PLANTAGO OVATA) 3,4 G PO VO EV 0.0000 2.4600 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 d17b3c5ae418d82694895a326dee545a ODILIA 12670516743 NULL 12670516743 02197 METAMUCIL (PLANTAGO OVATA) 3,4 G PO VO EV 0.0000 2.4600 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 d17b3c5ae418d82694895a326dee545a ODILIA 12670516743 NULL 12670516743 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 d17b3c5ae418d82694895a326dee545a ODILIA 12670516743 NULL 12670516743 44001 BOLSA COLETORA (SISTEMA ABERTO) UN 0.0000 0.3200 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 d17b3c5ae418d82694895a326dee545a ODILIA 12670516743 NULL 12670516743 51208 SORO RINGER SIMPLES 500 ML SI IV BS 0.0000 5.9400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 d17b3c5ae418d82694895a326dee545a ODILIA 12670516743 NULL 12670516743 51208 SORO RINGER SIMPLES 500 ML SI IV BS 0.0000 5.9400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 102001 DIARIA DE APARTAMENTO 0.0000 288.8881 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 102001 DIARIA DE APARTAMENTO 0.0000 288.8882 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 102001 DIARIA DE APARTAMENTO 0.0000 288.8881 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 11232 CLEXANE (ENOXAPARINA) 40 MG SI IV SC SE 0.0000 20.2466 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4092 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4074 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4074 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4074 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4074 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4072 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4072 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 01611 CLORETO DE POTASSIO 600 MG CA VO UN 0.0000 0.4867 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 01611 CLORETO DE POTASSIO 600 MG CA VO UN 0.0000 0.4867 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 01611 CLORETO DE POTASSIO 600 MG CA VO UN 0.0000 0.4867 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 02246 HIDROCORTISONA 100 MG PO IM IV FA 0.0000 2.8300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 02246 HIDROCORTISONA 100 MG PO IM IV FA 0.0000 2.8300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 02246 HIDROCORTISONA 100 MG PO IM IV FA 0.0000 2.8300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 02246 HIDROCORTISONA 100 MG PO IM IV FA 0.0000 2.8300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 00404 LACTULOSE 667 MG/ML XP VO ML 0.0000 0.2100 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 00404 LACTULOSE 667 MG/ML XP VO ML 0.0000 6.4300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 00404 LACTULOSE 667 MG/ML XP VO ML 0.0000 6.4300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.8067 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.8067 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.8067 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1771 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1771 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1771 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1771 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1771 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1771 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1771 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1771 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1771 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 00172 SORO FISIOLOGICO 0,9% 500 ML SI IV BS 0.0000 3.1426 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 24571 CLINDAMICINA 600 MG 4 ML SI IM IV AP 0.0000 13.0800 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 24571 CLINDAMICINA 600 MG 4 ML SI IM IV AP 0.0000 13.0800 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 24571 CLINDAMICINA 600 MG 4 ML SI IM IV AP 0.0000 13.0800 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 24571 CLINDAMICINA 600 MG 4 ML SI IM IV AP 0.0000 13.0800 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 24571 CLINDAMICINA 600 MG 4 ML SI IM IV AP 0.0000 13.0800 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 24571 CLINDAMICINA 600 MG 4 ML SI IM IV AP 0.0000 13.0800 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 24571 CLINDAMICINA 600 MG 4 ML SI IM IV AP 0.0000 13.0800 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 14191 OMEPRAZOL 20 MG CA VO UN 0.0000 0.9000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 00406 FUROSEMIDA 10 MG/ML 2 ML SI IM IV AP 0.0000 0.6000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 00406 FUROSEMIDA 10 MG/ML 2 ML SI IM IV AP 0.0000 1.2000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 00406 FUROSEMIDA 10 MG/ML 2 ML SI IM IV AP 0.0000 1.2000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.8100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 51584 ESPARADRAPO MICROPORE 0.0000 0.7700 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 06400 CARVEDILOL 3,125 MG CP VO UN 0.0000 0.7300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 06400 CARVEDILOL 3,125 MG CP VO UN 0.0000 0.7300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 06400 CARVEDILOL 3,125 MG CP VO UN 0.0000 0.7300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 102001 DIARIA DE APARTAMENTO 0.0000 288.8900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 102001 DIARIA DE APARTAMENTO 0.0000 288.8900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 102001 DIARIA DE APARTAMENTO 0.0000 288.8900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 102001 DIARIA DE APARTAMENTO 0.0000 288.8900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 00128 LUVA DE PROCEDIMENTO UNIDADE UN 0.0000 1.0000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 51589 ESPARADRAPO 10 X 4.5 CM CM 0.0000 0.4000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 51649 ALCOOL ETILICO 70 % ST TP ML 0.0000 0.0300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 00090 SERINGA DESC 20 ML UN 0.0000 0.5400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 00090 SERINGA DESC 20 ML UN 0.0000 0.5400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 00090 SERINGA DESC 20 ML UN 0.0000 0.5400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 00090 SERINGA DESC 20 ML UN 0.0000 0.5400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 00919 ALGODAO HIDROFILO BOLINHA UN 0.0000 0.2600 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 00919 ALGODAO HIDROFILO BOLINHA UN 0.0000 0.2600 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 00919 ALGODAO HIDROFILO BOLINHA UN 0.0000 0.2600 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 00943 EQUIPO POLIFIX 2 VIAS UN 0.0000 7.6500 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 f3ad474c8c562757c4d1a959ff0961c4 DJALMA 12718763240 NULL 12718763240 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 f3ad474c8c562757c4d1a959ff0961c4 DJALMA 12718763240 NULL 12718763240 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 f3ad474c8c562757c4d1a959ff0961c4 DJALMA 12718763240 NULL 12718763240 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 f3ad474c8c562757c4d1a959ff0961c4 DJALMA 12718763240 NULL 12718763240 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 f3ad474c8c562757c4d1a959ff0961c4 DJALMA 12718763240 NULL 12718763240 00037 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 f3ad474c8c562757c4d1a959ff0961c4 DJALMA 12718763240 NULL 12718763240 00037 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 f3ad474c8c562757c4d1a959ff0961c4 DJALMA 12718763240 NULL 12718763240 00037 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 f3ad474c8c562757c4d1a959ff0961c4 DJALMA 12718763240 NULL 12718763240 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 f3ad474c8c562757c4d1a959ff0961c4 DJALMA 12718763240 NULL 12718763240 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 f3ad474c8c562757c4d1a959ff0961c4 DJALMA 12718763240 NULL 12718763240 51584 ESPARADRAPO MICROPORE 0.0000 0.7700 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 f3ad474c8c562757c4d1a959ff0961c4 DJALMA 12718763240 NULL 12718763240 00090 SERINGA DESC 20 ML UN 0.0000 0.5400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 f3ad474c8c562757c4d1a959ff0961c4 DJALMA 12718763240 NULL 12718763240 00090 SERINGA DESC 20 ML UN 0.0000 0.5400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 f3ad474c8c562757c4d1a959ff0961c4 DJALMA 12718763240 NULL 12718763240 00090 SERINGA DESC 20 ML UN 0.0000 0.5400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 806bfa8e76209648a4ae145ff436d092 GILBERTO 12692620640 NULL 12692620640 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6875 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3fb5c891f31bb9efcb05395066127c52 ALAIDE 12636273441 NULL 12636273441 14250 PARACETAMOL 750 MG CP VO UN 0.0000 0.4500 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00090 SERINGA DESC 20 ML UN 0.5400 0.2200 0.3200 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00090 SERINGA DESC 20 ML UN 0.5400 0.2200 0.3200 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00090 SERINGA DESC 20 ML UN 0.5400 0.2200 0.3200 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00090 SERINGA DESC 20 ML UN 0.5400 0.2200 0.3200 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.6900 0.2700 0.4200 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.6900 0.2700 0.4200 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.6900 0.2700 0.4200 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.6900 0.2700 0.4200 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.6900 0.2700 0.4200 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.6900 0.2700 0.4200 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.6900 0.2700 0.4200 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.6900 0.2700 0.4200 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.6900 0.2700 0.4200 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.6900 0.2700 0.4200 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.6900 0.2700 0.4200 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.6900 0.2700 0.4200 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00471 LIDOCAINA 2% GE OU TP GR 2.5900 1.0100 1.5800 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00493 BROMOPRIDA 5 MG/ML 2 ML SI IM IV AP 2.7300 1.0600 1.6700 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00172 SORO FISIOLOGICO 0,9% 500 ML SI IV BS 4.7300 1.8400 2.8900 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 25040014 Fisioterapia Respiratória - em Doente Clínico Internado 5.0300 1.9600 3.0700 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 53144 TRAMAL 5.9900 2.3300 3.6600 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 53144 TRAMAL 5.9900 2.3300 3.6600 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00613 CLINDAMICINA 600 MG 4 ML SI IM IV AP 13.0800 5.1000 7.9800 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00613 CLINDAMICINA 600 MG 4 ML SI IM IV AP 13.0800 5.1000 7.9800 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 16b1e9f62f247f02ad5cac910ee15b4e BERCHOLINA 12631612848 NULL 12631612848 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4081 0.0019 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 16b1e9f62f247f02ad5cac910ee15b4e BERCHOLINA 12631612848 NULL 12631612848 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4081 0.0019 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 16b1e9f62f247f02ad5cac910ee15b4e BERCHOLINA 12631612848 NULL 12631612848 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4081 0.0019 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 16b1e9f62f247f02ad5cac910ee15b4e BERCHOLINA 12631612848 NULL 12631612848 33537 PIPERACILINA 2 G + TAZOBACTAM 250 MG 30 ML 55.3400 55.3386 0.0014 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 16b1e9f62f247f02ad5cac910ee15b4e BERCHOLINA 12631612848 NULL 12631612848 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4081 0.0019 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 16b1e9f62f247f02ad5cac910ee15b4e BERCHOLINA 12631612848 NULL 12631612848 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4081 0.0019 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 16b1e9f62f247f02ad5cac910ee15b4e BERCHOLINA 12631612848 NULL 12631612848 36432 HIDROCLOROTIAZIDA 25 MG CP VO UN 0.2400 0.2300 0.0100 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 16b1e9f62f247f02ad5cac910ee15b4e BERCHOLINA 12631612848 NULL 12631612848 00090 SERINGA DESC 20 ML UN 0.5400 0.5200 0.0200 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 16b1e9f62f247f02ad5cac910ee15b4e BERCHOLINA 12631612848 NULL 12631612848 00090 SERINGA DESC 20 ML UN 0.5400 0.5200 0.0200 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 16b1e9f62f247f02ad5cac910ee15b4e BERCHOLINA 12631612848 NULL 12631612848 00090 SERINGA DESC 20 ML UN 0.5400 0.5200 0.0200 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 16b1e9f62f247f02ad5cac910ee15b4e BERCHOLINA 12631612848 NULL 12631612848 00171 SORO FISIOLOGICO 0,9% 250 ML SI IV BS 3.9400 3.7600 0.1800 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 01081195 8cbe40d11795e1798bfc2eb87b3ce167 TANIA 12791026611 NULL 12791026611 00010014 CONSULTA EM CONSULTORIO MEDICO 0.0000 0.0000 50.0000 GUIA DE CONSULTA NAO EXECUTADA 0622
Glosa Min 2018-10-03 00:00:00.000000 1084117 b288bbcfb9aecab51bcb0dba62ca0059 IVONETE 12743730847 NULL 12743730847 55921 CISATRACURIO 20 MG 10 ML SI IV FR 117.6800 58.8400 58.8400 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 37761 ALCOOL ETILICO 70 % ST TP ML 0.0300 0.0200 0.0100 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 08648 ESPARADRAPO 10 X 4.5 CM CM 0.4000 0.2000 0.2000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 33219 LUVA DE PROCEDIMENTO UNIDADE UN 1.0000 0.6700 0.3300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 00817 ALGODAO HIDROFILO BOLINHA UN 0.2600 0.1300 0.1300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 05975 COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER 0.3000 0.1500 0.1500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 08648 ESPARADRAPO 10 X 4.5 CM CM 0.4000 0.2000 0.2000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 32891 EQUIPO POLIFIX 2ş VIAS UN 2.5500 0.0000 2.5500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 37761 ALCOOL ETILICO 70 % ST TP ML 0.0600 0.0200 0.0400 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 57495 FILTRO BARREIRA E REGENERADOR DE CALOR E UM 24.0000 0.0000 24.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 75bcd473a0dc7c7a6751499b38a4a034 JOAQUIM 12692852143 NULL 12692852143 08648 ESPARADRAPO 10 X 4.5 CM CM 0.4000 0.1000 0.3000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 75bcd473a0dc7c7a6751499b38a4a034 JOAQUIM 12692852143 NULL 12692852143 08648 ESPARADRAPO 10 X 4.5 CM CM 0.4000 0.1000 0.3000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 75bcd473a0dc7c7a6751499b38a4a034 JOAQUIM 12692852143 NULL 12692852143 37761 ALCOOL ETILICO 70 % ST TP ML 0.0300 0.0200 0.0100 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 75bcd473a0dc7c7a6751499b38a4a034 JOAQUIM 12692852143 NULL 12692852143 00817 ALGODAO HIDROFILO BOLINHA UN 0.2600 0.1300 0.1300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 75bcd473a0dc7c7a6751499b38a4a034 JOAQUIM 12692852143 NULL 12692852143 00817 ALGODAO HIDROFILO BOLINHA UN 0.2600 0.1300 0.1300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 4668d2494ed6c4b2d18be299efcb26a2 JOAO 12469689344 NULL 12469689344 37761 ALCOOL ETILICO 70 % ST TP ML 0.3000 0.2100 0.0900 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 4668d2494ed6c4b2d18be299efcb26a2 JOAO 12469689344 NULL 12469689344 11193 CLOREXIDINA 2 % ST TP ML 0.5300 0.2700 0.2600 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 4668d2494ed6c4b2d18be299efcb26a2 JOAO 12469689344 NULL 12469689344 08664 ESPARADRAPO MICROPORE 50 X 10 CM CM 0.7700 0.2600 0.5100 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 4668d2494ed6c4b2d18be299efcb26a2 JOAO 12469689344 NULL 12469689344 08648 ESPARADRAPO 10 X 4.5 CM CM 0.4000 0.2600 0.1400 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 32204 CLORETO DE SODIO 0,9% 10 ML SI IV AP 0.9600 0.0000 0.9600 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 19151 SERINGA DESC 10 ML UN 0.3300 0.0000 0.3300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 11134 HEPARINA 5000 UI/ML 5 ML SI IV SC ML 2.8800 0.0000 2.8800 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 32891 EQUIPO POLIFIX 2ş VIAS UN 2.5500 0.0000 2.5500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1900 0.0000 0.1900 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.0000 0.1000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12603877940 NULL 12603877940 08664 ESPARADRAPO MICROPORE 50 X 10 CM CM 0.7700 0.0000 0.7700 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 08664 ESPARADRAPO MICROPORE 50 X 10 CM CM 1.2800 0.5100 0.7700 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 33219 LUVA DE PROCEDIMENTO UNIDADE UN 1.0000 0.6700 0.3300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 33219 LUVA DE PROCEDIMENTO UNIDADE UN 1.0000 0.6700 0.3300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 33219 LUVA DE PROCEDIMENTO UNIDADE UN 1.0000 0.6700 0.3300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00817 ALGODAO HIDROFILO BOLINHA UN 0.2600 0.1300 0.1300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00035 ABOCATH (CATETER INTRAVENOSO) N. 14 A 22 UN 3.7700 0.0000 3.7700 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 08648 ESPARADRAPO 10 X 4.5 CM CM 0.4000 0.0000 0.4000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 33219 LUVA DE PROCEDIMENTO UNIDADE UN 1.0000 0.6700 0.3300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00817 ALGODAO HIDROFILO BOLINHA UN 0.2600 0.1300 0.1300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 22748 LIDOCAINA 2% GE TP OU GR 2.5900 1.3000 1.2900 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 28959 DERSANI LC TP ML 19.4000 9.7000 9.7000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 28959 DERSANI LC TP ML 19.4000 9.7000 9.7000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 33219 LUVA DE PROCEDIMENTO UNIDADE UN 1.0000 0.6700 0.3300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00817 ALGODAO HIDROFILO BOLINHA UN 0.2600 0.1300 0.1300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 11193 CLOREXIDINA 2 % ST TP ML 0.8000 0.0000 0.8000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 08664 ESPARADRAPO MICROPORE 50 X 10 CM CM 0.5100 0.3800 0.1300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 33227 LUVA CIRURGICA PAR UN 1.4500 0.0000 1.4500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12558131243 NULL 12558131243 08664 ESPARADRAPO MICROPORE 50 X 10 CM CM 2.5600 0.5100 2.0500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12558131243 NULL 12558131243 00817 ALGODAO HIDROFILO BOLINHA UN 0.5100 0.2600 0.2500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 0.0000 3.4100 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 6.4600 0.0000 6.4600 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 37761 ALCOOL ETILICO 70 % ST TP ML 0.0300 0.0200 0.0100 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 49824 NISTATINA 100.000 UI SU VO ML 0.3000 0.2950 0.0050 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 7c2bc8cd9bbf9ce081562a3c63fff8c9 MARTA 12647505849 NULL 12647505849 22896 CEFUROXIMA 750 MG + DIL. 6 ML PO IM IV FA 26.1300 26.1250 0.0050 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 f65f553befc0e3bc8bd5bce5c1c6e413 NAIRLENE 12633078944 NULL 12633078944 33219 LUVA DE PROCEDIMENTO UNIDADE UN 1.6700 1.6650 0.0050 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 f65f553befc0e3bc8bd5bce5c1c6e413 NAIRLENE 12633078944 NULL 12633078944 19160 SERINGA DESC 20 ML UN 0.5400 0.5363 0.0037 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 f65f553befc0e3bc8bd5bce5c1c6e413 NAIRLENE 12633078944 NULL 12633078944 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4067 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 f65f553befc0e3bc8bd5bce5c1c6e413 NAIRLENE 12633078944 NULL 12633078944 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4067 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 f65f553befc0e3bc8bd5bce5c1c6e413 NAIRLENE 12633078944 NULL 12633078944 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1760 0.0040 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 f65f553befc0e3bc8bd5bce5c1c6e413 NAIRLENE 12633078944 NULL 12633078944 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1760 0.0040 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 f65f553befc0e3bc8bd5bce5c1c6e413 NAIRLENE 12633078944 NULL 12633078944 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1760 0.0040 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 f65f553befc0e3bc8bd5bce5c1c6e413 NAIRLENE 12633078944 NULL 12633078944 07269 DIPIRONA 500 MG/ML 2 ML SI IV IM AP 0.6900 0.6864 0.0036 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 f93cee6f501560245a8f94ffc5c6c246 ROSEDALIA 12622895145 NULL 12622895145 19160 SERINGA DESC 20 ML UN 0.5400 0.5370 0.0030 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 f93cee6f501560245a8f94ffc5c6c246 ROSEDALIA 12622895145 NULL 12622895145 19160 SERINGA DESC 20 ML UN 0.5400 0.5373 0.0027 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 026c6dcfddc3d74250c79f449289696a SALOMAO 12456038443 NULL 12456038443 30813 DEXCLORFENIRAMINA 2 MG CP VO UN 0.3300 0.3200 0.0000 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 d4089ccef13567fd45b16fb0b60685fa VERA 12640482546 NULL 12640482546 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1754 0.0046 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 d4089ccef13567fd45b16fb0b60685fa VERA 12640482546 NULL 12640482546 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1754 0.0046 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 d4089ccef13567fd45b16fb0b60685fa VERA 12640482546 NULL 12640482546 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1754 0.0046 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 d4089ccef13567fd45b16fb0b60685fa VERA 12640482546 NULL 12640482546 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1754 0.0046 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 d4089ccef13567fd45b16fb0b60685fa VERA 12640482546 NULL 12640482546 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1754 0.0046 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4074 0.0026 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4074 0.0026 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4074 0.0026 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4074 0.0026 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 19160 SERINGA DESC 20 ML UN 0.5400 0.5372 0.0028 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 19160 SERINGA DESC 20 ML UN 0.5400 0.5372 0.0028 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 19160 SERINGA DESC 20 ML UN 0.5400 0.5372 0.0028 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 19160 SERINGA DESC 20 ML UN 0.5400 0.5372 0.0028 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 19160 SERINGA DESC 20 ML UN 0.5400 0.5372 0.0028 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 19160 SERINGA DESC 20 ML UN 0.5400 0.5372 0.0028 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 19160 SERINGA DESC 20 ML UN 0.5400 0.5372 0.0028 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 19160 SERINGA DESC 20 ML UN 0.5400 0.5372 0.0028 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 19160 SERINGA DESC 20 ML UN 1.0800 1.0744 0.0056 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1d6bbb4a00130e2e654e830fc9bae6a ALEXANDRINA 12694224940 NULL 12694224940 17892 NEOSTIGMINA 0,5 MG/ML 1 ML SI SC IM IV AP 0.7700 0.7600 0.0000 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1d6bbb4a00130e2e654e830fc9bae6a ALEXANDRINA 12694224940 NULL 12694224940 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4072 0.0028 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1d6bbb4a00130e2e654e830fc9bae6a ALEXANDRINA 12694224940 NULL 12694224940 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4072 0.0028 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1d6bbb4a00130e2e654e830fc9bae6a ALEXANDRINA 12694224940 NULL 12694224940 19160 SERINGA DESC 20 ML UN 0.5400 0.5367 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1d6bbb4a00130e2e654e830fc9bae6a ALEXANDRINA 12694224940 NULL 12694224940 19160 SERINGA DESC 20 ML UN 0.5400 0.5367 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 345c226bfea274af1372d41b0305a6c8 ALTINO 12720257940 NULL 12720257940 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1000 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 345c226bfea274af1372d41b0305a6c8 ALTINO 12720257940 NULL 12720257940 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1000 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 345c226bfea274af1372d41b0305a6c8 ALTINO 12720257940 NULL 12720257940 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1000 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1038 -0.0038 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1038 -0.0038 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1038 -0.0038 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1038 -0.0038 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1038 -0.0038 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 19160 SERINGA DESC 20 ML UN 0.5400 0.5378 0.0022 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 19160 SERINGA DESC 20 ML UN 0.5400 0.5378 0.0022 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 19160 SERINGA DESC 20 ML UN 0.5400 0.5378 0.0022 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 19160 SERINGA DESC 20 ML UN 0.5400 0.5378 0.0022 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 19160 SERINGA DESC 20 ML UN 0.5400 0.5378 0.0022 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1797 0.0003 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1797 0.0003 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1797 0.0003 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1797 0.0003 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.4000 0.4045 -0.0045 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.4000 0.4045 -0.0045 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8091 0.0009 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 20567 SORO FISIOLOGICO 0,9% 500 ML SI IV BS 4.7300 4.7350 -0.0050 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 20567 SORO FISIOLOGICO 0,9% 500 ML SI IV BS 4.7300 4.7350 -0.0050 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 20567 SORO FISIOLOGICO 0,9% 500 ML SI IV BS 4.7300 4.7350 -0.0050 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 05975 COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER 0.3000 0.0000 0.3000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 05975 COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER 0.3000 0.0000 0.3000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 05975 COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER 0.3000 0.0000 0.3000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 670141098c0309ac9be3db204bdc12cf LEOSINA 12706525442 NULL 12706525442 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1767 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 27480 CLARITROMICINA 500 MG 30 ML PO IV FA 117.1100 117.1050 0.0050 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1764 0.0036 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1758 0.0042 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1758 0.0042 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1758 0.0042 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1758 0.0042 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1758 0.0042 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1758 0.0042 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4084 0.0016 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4084 0.0016 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4084 0.0016 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4084 0.0016 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 19160 SERINGA DESC 20 ML UN 0.5400 0.5384 0.0016 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 19160 SERINGA DESC 20 ML UN 0.5400 0.5384 0.0016 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 19160 SERINGA DESC 20 ML UN 0.5400 0.5384 0.0016 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 19445 CLORETO DE POTASSIO 600 MG CA VO UN 0.4900 0.4861 0.0039 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4075 0.0025 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4075 0.0025 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4075 0.0025 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4075 0.0025 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 07269 DIPIRONA 500 MG/ML 2 ML SI IV IM AP 0.6900 0.6865 0.0035 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 07269 DIPIRONA 500 MG/ML 2 ML SI IV IM AP 0.6900 0.6865 0.0035 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 07269 DIPIRONA 500 MG/ML 2 ML SI IV IM AP 0.6900 0.6865 0.0035 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 07269 DIPIRONA 500 MG/ML 2 ML SI IV IM AP 0.6900 0.6865 0.0035 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 07269 DIPIRONA 500 MG/ML 2 ML SI IV IM AP 0.6900 0.6865 0.0035 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 07269 DIPIRONA 500 MG/ML 2 ML SI IV IM AP 0.6900 0.6865 0.0035 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 19160 SERINGA DESC 20 ML UN 0.5400 0.5375 0.0025 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1769 0.0031 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1769 0.0031 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8073 0.0027 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 19160 SERINGA DESC 20 ML UN 0.5400 0.5372 0.0028 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 19160 SERINGA DESC 20 ML UN 0.5400 0.5372 0.0028 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 19160 SERINGA DESC 20 ML UN 0.5400 0.5372 0.0028 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 19160 SERINGA DESC 20 ML UN 0.5400 0.5372 0.0028 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1779 0.0021 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1779 0.0021 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1779 0.0021 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1900 0.1779 0.0121 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 08664 ESPARADRAPO MICROPORE 50 X 10 CM CM 0.2600 0.2558 0.0042 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e2b254ce765be196b019032789d8f852 MARIA 12576216044 NULL 12576216044 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4076 0.0024 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 19135 SERINGA DESC 03 ML UN 0.3000 0.3000 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 19135 SERINGA DESC 03 ML UN 0.1500 0.0000 0.1500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 d17b3c5ae418d82694895a326dee545a ODILIA 12670516743 NULL 12670516743 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1774 0.0026 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00817 ALGODAO HIDROFILO BOLINHA UN 0.3800 0.1300 0.2500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 6ccea6ac8c216c032723aee73a9f81c9 PRISCILA 12662249242 NULL 12662249242 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4065 0.0035 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 6ccea6ac8c216c032723aee73a9f81c9 PRISCILA 12662249242 NULL 12662249242 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8075 0.0025 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 6ccea6ac8c216c032723aee73a9f81c9 PRISCILA 12662249242 NULL 12662249242 07269 DIPIRONA 500 MG/ML 2 ML SI IV IM AP 0.6900 0.6864 0.0036 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 6ccea6ac8c216c032723aee73a9f81c9 PRISCILA 12662249242 NULL 12662249242 19160 SERINGA DESC 20 ML UN 0.5400 0.5373 0.0027 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 6ccea6ac8c216c032723aee73a9f81c9 PRISCILA 12662249242 NULL 12662249242 19160 SERINGA DESC 20 ML UN 0.5400 0.5373 0.0027 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1000 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1000 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1000 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1000 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1000 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1000 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1000 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1000 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1000 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1000 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1000 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1000 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1000 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1000 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.4000 0.0000 0.4000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 1.2100 0.0000 1.2100 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 33227 LUVA CIRURGICA PAR UN 1.4500 1.4476 0.0024 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 19160 SERINGA DESC 20 ML UN 0.5400 0.5384 0.0016 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 19160 SERINGA DESC 20 ML UN 0.5400 0.5384 0.0016 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 19160 SERINGA DESC 20 ML UN 0.5400 0.5384 0.0016 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1776 0.0024 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1776 0.0024 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1776 0.0024 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1776 0.0024 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1776 0.0024 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1776 0.0024 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 53660 EQUIPO MACRO-GOTAS FLEXIVEL C/ INJETOR LATE 1.5900 1.5900 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8092 0.0008 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8092 0.0008 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 11193 CLOREXIDINA 2 % ST TP ML 0.5300 0.5300 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 6799aa3de305405ab065aad5b599765c VANIR 12700232345 NULL 12700232345 07269 DIPIRONA 500 MG/ML 2 ML SI IV IM AP 0.6900 0.6870 0.0030 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 0111beed375944f60c7ad4a7fd4874f8 WALDIR 12746025744 NULL 12746025744 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1773 0.0027 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 05975 COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER 0.3000 0.0000 0.3000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8079 0.0021 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 610c198ec4c064687cf0524f147d3aed ROBERTO 12748814743 NULL 12748814743 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1767 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 610c198ec4c064687cf0524f147d3aed ROBERTO 12748814743 NULL 12748814743 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1767 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 610c198ec4c064687cf0524f147d3aed ROBERTO 12748814743 NULL 12748814743 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4083 0.0017 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 610c198ec4c064687cf0524f147d3aed ROBERTO 12748814743 NULL 12748814743 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4083 0.0017 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 610c198ec4c064687cf0524f147d3aed ROBERTO 12748814743 NULL 12748814743 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4083 0.0017 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12647284040 NULL 12647284040 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1750 0.0050 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12647284040 NULL 12647284040 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4086 0.0014 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12647284040 NULL 12647284040 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4086 0.0014 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12647284040 NULL 12647284040 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4086 0.0014 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12647284040 NULL 12647284040 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4086 0.0014 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 01081195 71f5440171ef97870d290cb22b5aa301 ITAMAR 12750223317 NULL 12750223317 00010014 CONSULTA EM CONSULTORIO MEDICO 0.0000 35.0000 NULL ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 01081197 48a4767d340a20e9055db1a855afdfff REGINA 12675950024 NULL 12675950024 32050038 TORAX PA 0.0000 11.0271 NULL ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 11193 CLOREXIDINA 2 % ST TP ML 0.8000 0.0000 0.8000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 08664 ESPARADRAPO MICROPORE 50 X 10 CM CM 0.2600 0.0000 0.2600 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 50644 MORFINA 10 MG/ML 1 ML SI IM IV PE IT AP 2.6400 2.6400 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 33545 PIPERACILINA 4 G + TAZOBACTAM 500 MG PO IV 83.4500 83.4500 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 33545 PIPERACILINA 4 G + TAZOBACTAM 500 MG PO IV 83.4500 83.4500 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 33545 PIPERACILINA 4 G + TAZOBACTAM 500 MG PO IV 83.4500 83.4500 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 6.8145 -3.4045 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 6.8145 -3.4045 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 6.8145 -3.4045 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 6.8145 -3.4045 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 6.8145 -3.4045 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 6.8145 -3.4045 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 6.8145 -3.4045 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4072 0.0028 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4072 0.0028 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4072 0.0028 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4072 0.0028 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4072 0.0028 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4072 0.0028 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4072 0.0028 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4072 0.0028 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.2120 -0.1120 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.2120 -0.1120 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 19160 SERINGA DESC 20 ML UN 0.5400 0.5374 0.0026 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 19160 SERINGA DESC 20 ML UN 0.5400 0.5374 0.0026 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 19160 SERINGA DESC 20 ML UN 0.5400 0.5374 0.0026 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 19160 SERINGA DESC 20 ML UN 0.5400 0.5374 0.0026 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 19160 SERINGA DESC 20 ML UN 0.5400 0.5374 0.0026 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 19160 SERINGA DESC 20 ML UN 0.5400 0.5374 0.0026 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 19160 SERINGA DESC 20 ML UN 0.5400 0.5374 0.0026 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.4000 0.4037 -0.0037 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.4000 0.4037 -0.0037 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.4000 0.4037 -0.0037 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8073 0.0027 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8073 0.0027 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8073 0.0027 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8073 0.0027 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 13757 IODOPOVIDONA SD TP ML 0.4000 0.4000 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 33219 LUVA DE PROCEDIMENTO UNIDADE UN 1.0000 1.0050 -0.0050 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 09636 FLORATIL (SACCHAROMYCES BOULARDII) 200 MG P 4.4400 8.8851 -4.4451 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 09636 FLORATIL (SACCHAROMYCES BOULARDII) 200 MG P 4.4400 8.8851 -4.4451 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 05975 COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER 0.8339 0.8679 -0.7779 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 05975 COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER 1.3129 1.3638 -0.7638 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 28959 DERSANI LC TP ML 12.6100 13.5800 -3.8800 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 55018 ALGINATO DE CALCIO EM HIDROGEL GL TP GR 3.4500 3.4500 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 55018 ALGINATO DE CALCIO EM HIDROGEL GL TP GR 58.6500 58.6500 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 08664 ESPARADRAPO MICROPORE 50 X 10 CM CM 1.3564 1.3849 -0.8749 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1d6bbb4a00130e2e654e830fc9bae6a ALEXANDRINA 12694224940 NULL 12694224940 05274 AMOXICILINA 500 MG + CLAVULANATO 125 MG CP 3.1700 3.1667 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 17252 LIDOCAINA 2% GE OU TP GR NULL 0.0000 NULL OPME INVALIDO 2201
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 51584 ESPARADRAPO MICROPORE NULL 0.0000 NULL OPME INVALIDO 2201
Glosa Min 2018-10-03 00:00:00.000000 1084117 800720d33fe0defb6121e82dd216d044 JALMO 12786952647 NULL 12786952647 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 800720d33fe0defb6121e82dd216d044 JALMO 12786952647 NULL 12786952647 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 800720d33fe0defb6121e82dd216d044 JALMO 12786952647 NULL 12786952647 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 800720d33fe0defb6121e82dd216d044 JALMO 12786952647 NULL 12786952647 00037 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 752c651cb4fd049e19c685f87fbe8bdc EDUARDO 12765990646 NULL 12765990646 00172 SORO FISIOLOGICO 0,9% 500 ML SI IV BS 0.0000 9.4700 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 752c651cb4fd049e19c685f87fbe8bdc EDUARDO 12765990646 NULL 12765990646 00172 SORO FISIOLOGICO 0,9% 500 ML SI IV BS 0.0000 9.4700 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 752c651cb4fd049e19c685f87fbe8bdc EDUARDO 12765990646 NULL 12765990646 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6875 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 752c651cb4fd049e19c685f87fbe8bdc EDUARDO 12765990646 NULL 12765990646 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6875 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12558131243 NULL 12558131243 00128 LUVA DE PROCEDIMENTO UNIDADE UN 0.0000 0.6680 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12558131243 NULL 12558131243 25040014 Fisioterapia Respiratória - em Doente Clínico Internado 0.0000 12.2800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12558131243 NULL 12558131243 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 1.3600 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12558131243 NULL 12558131243 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1757 NULL VALOR APRESENTADO A MAIOR 1705
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12558131243 NULL 12558131243 52010511 Fratura do Cóccix - Tratamento Cruento 0.0000 0.0000 NULL COBRANCA DE HONORARIOS EM DUPLICIDADE 2607
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12558131243 NULL 12558131243 52010511 Fratura do Cóccix - Tratamento Cruento 0.0000 0.0000 NULL COBRANCA DE HONORARIOS EM DUPLICIDADE 2607
Glosa Min 2018-10-03 00:00:00.000000 1084117 526685c1041cc1316e874a2e95e67e2e JOSE 12696604949 NULL 12696604949 00090 SERINGA DESC 20 ML UN 0.0000 0.5367 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 11232 CLEXANE (ENOXAPARINA) 40 MG SI IV SC SE 0.0000 38.9400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 11700 EQUIPO P/ BOMBA DE INFUSAO ENTERAL / PARENTERAL 0.0000 20.2800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 11700 EQUIPO P/ BOMBA DE INFUSAO ENTERAL / PARENTERAL 0.0000 0.0000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.0000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.0000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.0000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.0000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.4000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.4000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.4000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.4000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.4000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 51164 AGUA BIDESTILADA 500 ML 0.0000 6.4300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 51164 AGUA BIDESTILADA 500 ML 0.0000 6.4300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.0000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.0000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 51379 SERINGA DESC 05 ML UN 0.0000 0.1900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 51379 SERINGA DESC 05 ML UN 0.0000 0.1900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 51379 SERINGA DESC 05 ML UN 0.0000 0.1900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 51379 SERINGA DESC 05 ML UN 0.0000 0.1900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 51434 BECLOMETASONA 400 MCG / ML 2 ML SL IN FL 0.0000 4.4800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 51434 BECLOMETASONA 400 MCG / ML 2 ML SL IN FL 0.0000 4.4800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 51434 BECLOMETASONA 400 MCG / ML 2 ML SL IN FL 0.0000 4.4800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 51434 BECLOMETASONA 400 MCG / ML 2 ML SL IN FL 0.0000 4.4800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 51434 BECLOMETASONA 400 MCG / ML 2 ML SL IN FL 0.0000 4.4800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 51434 BECLOMETASONA 400 MCG / ML 2 ML SL IN FL 0.0000 4.4800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 51434 BECLOMETASONA 400 MCG / ML 2 ML SL IN FL 0.0000 4.4800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 51708 Dieta Hipercalorica Hiperproteica Sem Fibras 1.5 kcal 0.0000 73.4000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00613 CLINDAMICINA 600 MG 4 ML SI IM IV AP 0.0000 13.0800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00098 ABOCATH N 14 A 22 UN 0.0000 3.7700 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 51378 SERINGA DESC 03 ML UN 0.0000 0.0000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 4e13adf421809cb755e1bdd80cc4efed AGRIPINA 12385409142 NULL 12385409142 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.4000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 75bcd473a0dc7c7a6751499b38a4a034 JOAQUIM 12692852143 NULL 12692852143 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4075 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 75bcd473a0dc7c7a6751499b38a4a034 JOAQUIM 12692852143 NULL 12692852143 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4075 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 75bcd473a0dc7c7a6751499b38a4a034 JOAQUIM 12692852143 NULL 12692852143 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4075 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 75bcd473a0dc7c7a6751499b38a4a034 JOAQUIM 12692852143 NULL 12692852143 01652 TRAMADOL 50 MG CP VO UN 0.0000 1.9272 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 75bcd473a0dc7c7a6751499b38a4a034 JOAQUIM 12692852143 NULL 12692852143 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6850 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 75bcd473a0dc7c7a6751499b38a4a034 JOAQUIM 12692852143 NULL 12692852143 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6850 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 75bcd473a0dc7c7a6751499b38a4a034 JOAQUIM 12692852143 NULL 12692852143 04073 TRAMADOL 50 MG 1 ML SI IM IV AP 0.0000 4.1900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 75bcd473a0dc7c7a6751499b38a4a034 JOAQUIM 12692852143 NULL 12692852143 000441 TAXA DE DELEUCOTIZAÇÃO 0.0000 0.0000 NULL COBRANCA DE TAXAS, DE SERVICOS REALIZADOS EM AMBIENTES INCOMPATIVEIS COM O USO DE EQUIPAMENTOS 2407
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00124 LUVA CIRURGICA UN 0.0000 1.4500 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 26981 SORO FISIOLOGICO 0,9% 10 ML SI IV AP 0.0000 0.4800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 26981 SORO FISIOLOGICO 0,9% 10 ML SI IV AP 0.0000 0.9600 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 26981 SORO FISIOLOGICO 0,9% 10 ML SI IV AP 0.0000 0.9600 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 26981 SORO FISIOLOGICO 0,9% 10 ML SI IV AP 0.0000 0.9600 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 26981 SORO FISIOLOGICO 0,9% 10 ML SI IV AP 0.0000 0.9600 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 26981 SORO FISIOLOGICO 0,9% 10 ML SI IV AP 0.0000 0.9600 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6875 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 35382 COMPRESSAS DE GASES 7.5 X7,5 (11 FIOS ESTERIL) UN 0.0000 0.0900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00487 RANITIDINA 25 MG/ML 2 ML SI IM IV AP 0.0000 0.0000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00487 RANITIDINA 25 MG/ML 2 ML SI IM IV AP 0.0000 0.9300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 51578 Frasco p/ alimentacao enteral 0.0000 2.4700 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 51578 Frasco p/ alimentacao enteral 0.0000 2.4700 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 54035 LIDOCAINA 2% C/ VASO SI IM PE ML 0.0000 0.6800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 54756 HIDANTAL 0.0000 0.1864 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 54756 HIDANTAL 0.0000 0.1864 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00796 FLORATIL (SACCHAROMYCES BOULARDII) 200 MG PO VO 0.0000 4.4400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4088 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4088 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4088 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4088 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4088 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4088 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6872 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6872 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6872 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1766 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1766 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1766 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1766 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1766 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1766 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4070 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4070 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 22421 PIPERACILINA 2 G + TAZOBACTAM 250 MG 30 ML PO IV 0.0000 55.3400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 22421 PIPERACILINA 2 G + TAZOBACTAM 250 MG 30 ML PO IV 0.0000 55.3400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.4000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 51584 ESPARADRAPO MICROPORE 0.0000 0.2560 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 52303 NOREPINEFRINA 2 MG/ML 4 ML SI IV AP 0.0000 9.4962 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 52303 NOREPINEFRINA 2 MG/ML 4 ML SI IV AP 0.0000 37.9900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 52537 Cateter Hemodialise Duplo Lumen 11,5fr X 20cm 0.0000 183.0000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cd2840524be5a3f1d0939f241e24f32b MARIA 12705908340 NULL 12705908340 00181 SULFATO DE MAGNESIO 100 MG/ML 10 ML SI IM IV 0.0000 0.9467 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cd2840524be5a3f1d0939f241e24f32b MARIA 12705908340 NULL 12705908340 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cd2840524be5a3f1d0939f241e24f32b MARIA 12705908340 NULL 12705908340 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cd2840524be5a3f1d0939f241e24f32b MARIA 12705908340 NULL 12705908340 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cd2840524be5a3f1d0939f241e24f32b MARIA 12705908340 NULL 12705908340 00090 SERINGA DESC 20 ML UN 0.0000 0.5400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cd2840524be5a3f1d0939f241e24f32b MARIA 12705908340 NULL 12705908340 00090 SERINGA DESC 20 ML UN 0.0000 0.5400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 51659 FENOTEROL 2 MG/ML 10 ML AE IN DS 0.0000 3.4000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 00090 SERINGA DESC 20 ML UN 0.0000 0.5379 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 00090 SERINGA DESC 20 ML UN 0.0000 0.5379 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 00090 SERINGA DESC 20 ML UN 0.0000 0.5379 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 01611 CLORETO DE POTASSIO 600 MG CA VO UN 0.0000 0.4867 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 01611 CLORETO DE POTASSIO 600 MG CA VO UN 0.0000 0.4867 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.8100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.8078 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.8078 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.8078 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 51208 SORO RINGER SIMPLES 500 ML SI IV BS 0.0000 5.9400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1772 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1773 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1773 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1773 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1773 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1773 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1773 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 51660 BROMETO DE IPRATROPIO SL IN GT 0.0000 0.2974 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4094 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4094 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4094 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4094 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 01496 FENITOINA 50 MG/ML 5 ML SI IM IV AP 0.0000 2.3400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 02246 HIDROCORTISONA 100 MG PO IM IV FA 0.0000 2.8300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 02246 HIDROCORTISONA 100 MG PO IM IV FA 0.0000 2.8300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 02246 HIDROCORTISONA 100 MG PO IM IV FA 0.0000 2.8300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 26981 SORO FISIOLOGICO 0,9% 10 ML SI IV AP 0.0000 0.9600 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 26981 SORO FISIOLOGICO 0,9% 10 ML SI IV AP 0.0000 0.9600 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 26981 SORO FISIOLOGICO 0,9% 10 ML SI IV AP 0.0000 0.9600 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 26981 SORO FISIOLOGICO 0,9% 10 ML SI IV AP 0.0000 0.9600 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 26981 SORO FISIOLOGICO 0,9% 10 ML SI IV AP 0.0000 0.9600 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 26981 SORO FISIOLOGICO 0,9% 10 ML SI IV AP 0.0000 0.9600 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 26981 SORO FISIOLOGICO 0,9% 10 ML SI IV AP 0.0000 0.9600 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 09070 ACETILCISTEINA 600MG PO VO SA 0.0000 3.4950 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 00091 SERINGA DESC 01 ML (INSULINA) UN 0.0000 0.3100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 15f461c0ca379f375bd9f8b18fbb101a ANA 12753753845 NULL 12753753845 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR APRESENTADO A MAIOR 1705
Glosa Min 2018-10-03 00:00:00.000000 1084117 15f461c0ca379f375bd9f8b18fbb101a ANA 12753753845 NULL 12753753845 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR APRESENTADO A MAIOR 1705
Glosa Min 2018-10-03 00:00:00.000000 1084117 15f461c0ca379f375bd9f8b18fbb101a ANA 12753753845 NULL 12753753845 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL COBRANCA DE HONORARIOS EM DUPLICIDADE 2607
Glosa Min 2018-10-03 00:00:00.000000 1084117 15f461c0ca379f375bd9f8b18fbb101a ANA 12753753845 NULL 12753753845 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.4000 NULL VALOR APRESENTADO A MAIOR 1705
Glosa Min 2018-10-03 00:00:00.000000 1084117 15f461c0ca379f375bd9f8b18fbb101a ANA 12753753845 NULL 12753753845 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.4000 NULL VALOR APRESENTADO A MAIOR 1705
Glosa Min 2018-10-03 00:00:00.000000 1084117 15f461c0ca379f375bd9f8b18fbb101a ANA 12753753845 NULL 12753753845 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 15f461c0ca379f375bd9f8b18fbb101a ANA 12753753845 NULL 12753753845 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1800 NULL VALOR APRESENTADO A MAIOR 1705
Glosa Min 2018-10-03 00:00:00.000000 1084117 15f461c0ca379f375bd9f8b18fbb101a ANA 12753753845 NULL 12753753845 55279 TRAMADOL 50 MG 1 ML SI IM IV AP 0.0000 4.1900 NULL COBRANCA DE MEDICAMENTO INCOMPATIVEL COM O RELATORIO TECNICO 2112
Glosa Min 2018-10-03 00:00:00.000000 1084117 15f461c0ca379f375bd9f8b18fbb101a ANA 12753753845 NULL 12753753845 00657 CEFAZOLINA 1 GR + DIL. 10 ML PO IM IV FA 0.0000 8.1300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00124 LUVA CIRURGICA UN 0.0000 1.4475 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4072 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4072 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4072 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4072 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4072 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4072 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4072 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4072 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4072 NULL COBRANCA DE MEDICAMENTO EM QUANTIDADE INCOMPATIVEL COM A PERMANENCIA 2107
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4072 NULL VALOR APRESENTADO A MAIOR 1705
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4072 NULL VALOR APRESENTADO A MAIOR 1705
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4072 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4072 NULL VALOR APRESENTADO A MAIOR 1705
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4072 NULL COBRANCA DE MEDICAMENTO EM QUANTIDADE INCOMPATIVEL COM A PERMANENCIA 2107
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4072 NULL COBRANCA DE MEDICAMENTO EM QUANTIDADE INCOMPATIVEL COM A PERMANENCIA 2107
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 01611 CLORETO DE POTASSIO 600 MG CA VO UN 0.0000 0.4870 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 01611 CLORETO DE POTASSIO 600 MG CA VO UN 0.0000 0.4870 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 02355 AMOXICILINA 1 G + CLAVULANATO 200 MG + DIL. 10 ML 0.0000 36.4667 NULL COBRANCA DE MEDICAMENTO EM QUANTIDADE INCOMPATIVEL COM A PERMANENCIA 2107
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 02355 AMOXICILINA 1 G + CLAVULANATO 200 MG + DIL. 10 ML 0.0000 36.4667 NULL COBRANCA DE MEDICAMENTO EM QUANTIDADE INCOMPATIVEL COM A PERMANENCIA 2107
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 02355 AMOXICILINA 1 G + CLAVULANATO 200 MG + DIL. 10 ML 0.0000 36.4667 NULL COBRANCA DE MEDICAMENTO EM QUANTIDADE INCOMPATIVEL COM A PERMANENCIA 2107
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 02355 AMOXICILINA 1 G + CLAVULANATO 200 MG + DIL. 10 ML 0.0000 36.4667 NULL COBRANCA DE MEDICAMENTO EM QUANTIDADE INCOMPATIVEL COM A PERMANENCIA 2107
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00069 SERINGA DESC 10 ML UN 0.0000 0.6657 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00090 SERINGA DESC 20 ML UN 0.0000 0.5367 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00090 SERINGA DESC 20 ML UN 0.0000 0.5367 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00090 SERINGA DESC 20 ML UN 0.0000 0.5367 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00090 SERINGA DESC 20 ML UN 0.0000 0.5367 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00090 SERINGA DESC 20 ML UN 0.0000 0.5367 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 2e6b6f291f2df9beb1fbda6028678909 ANNA 12463693448 NULL 12463693448 00184 CLORETO DE POTASSIO 10% 10 ML SI IV AP 0.0000 0.8900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 2e6b6f291f2df9beb1fbda6028678909 ANNA 12463693448 NULL 12463693448 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00124 LUVA CIRURGICA UN 0.0000 1.4478 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00124 LUVA CIRURGICA UN 0.0000 1.4478 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00124 LUVA CIRURGICA UN 0.0000 1.4478 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6871 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 35382 COMPRESSAS DE GASES 7.5 X7,5 (11 FIOS ESTERIL) UN 0.0000 0.3000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00487 RANITIDINA 25 MG/ML 2 ML SI IM IV AP 0.0000 0.9300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00487 RANITIDINA 25 MG/ML 2 ML SI IM IV AP 0.0000 0.9300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00487 RANITIDINA 25 MG/ML 2 ML SI IM IV AP 0.0000 0.9300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.4000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.4000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.4000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.4000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.4000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1776 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1776 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 51588 ESPARADRAPO MICROPORE 50 X 10 CM CM 0.0000 0.2600 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 51649 ALCOOL ETILICO 70 % ST TP ML 0.0000 0.0300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 54157 EQUIPO P/ DIETA ENTERAL UN 0.0000 1.7000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 54157 EQUIPO P/ DIETA ENTERAL UN 0.0000 1.7000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00090 SERINGA DESC 20 ML UN 0.0000 0.5375 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00090 SERINGA DESC 20 ML UN 0.0000 0.5375 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00090 SERINGA DESC 20 ML UN 0.0000 0.5375 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00090 SERINGA DESC 20 ML UN 0.0000 0.5375 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00090 SERINGA DESC 20 ML UN 0.0000 0.5375 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00096 ABOCATH N 14 A 22 UN 0.0000 3.7660 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00097 ABOCATH N 14 A 22 UN 0.0000 3.7660 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 03280 CLOREXIDINA 2 % ST TP ML 0.0000 0.8000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 03280 CLOREXIDINA 2 % ST TP ML 0.0000 0.8000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.0000 NULL FALTA PRESCRICAO MEDICA 1709
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.8074 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.8074 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.8074 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.8074 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.8074 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1775 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1775 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1775 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1775 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1775 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1775 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1775 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1775 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 51584 ESPARADRAPO MICROPORE 0.0000 0.3800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 51584 ESPARADRAPO MICROPORE 0.0000 0.0000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 51671 REPARIL (ESCINA + DIETILAMONIO) GL TP GR 0.0000 3.7500 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 00090 SERINGA DESC 20 ML UN 0.0000 0.5375 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 00090 SERINGA DESC 20 ML UN 0.0000 0.5375 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 00090 SERINGA DESC 20 ML UN 0.0000 0.5375 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 00090 SERINGA DESC 20 ML UN 0.0000 0.5375 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 00090 SERINGA DESC 20 ML UN 0.0000 0.5375 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 00090 SERINGA DESC 20 ML UN 0.0000 0.5375 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 00090 SERINGA DESC 20 ML UN 0.0000 0.5375 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 00090 SERINGA DESC 20 ML UN 0.0000 0.5375 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 00127 LUVA DE PROCEDIMENTO UNIDADE UN 0.0000 1.6700 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 00127 LUVA DE PROCEDIMENTO UNIDADE UN 0.0000 0.1664 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 01691 NISTATINA 100.000 UI/ML SU VO ML 0.0000 0.2950 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 01691 NISTATINA 100.000 UI/ML SU VO ML 0.0000 0.2950 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 01691 NISTATINA 100.000 UI/ML SU VO ML 0.0000 0.2950 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 20691 HIDROCORTISONA 100 MG PO IM IV FA 0.0000 2.8300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 20691 HIDROCORTISONA 100 MG PO IM IV FA 0.0000 2.8300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 04963 PANTOPRAZOL 40 MG CP VO UN 0.0000 3.4600 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1765 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1765 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1765 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1765 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1765 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 51241 AGULHA 123X45 0.0000 0.1900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 51241 AGULHA 123X45 0.0000 0.1900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 51241 AGULHA 123X45 0.0000 0.1900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 51241 AGULHA 123X45 0.0000 0.1900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 51241 AGULHA 123X45 0.0000 0.1900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 00090 SERINGA DESC 20 ML UN 0.0000 0.5373 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 00090 SERINGA DESC 20 ML UN 0.0000 0.5373 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 00090 SERINGA DESC 20 ML UN 0.0000 0.5373 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 00090 SERINGA DESC 20 ML UN 0.0000 0.5373 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 00090 SERINGA DESC 20 ML UN 0.0000 0.5373 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 00919 ALGODAO HIDROFILO BOLINHA UN 0.0000 0.0400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 61e4786d45edfdbf19b77fb2c6ce6b9c REINALDO 12754482747 NULL 12754482747 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 61e4786d45edfdbf19b77fb2c6ce6b9c REINALDO 12754482747 NULL 12754482747 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 61e4786d45edfdbf19b77fb2c6ce6b9c REINALDO 12754482747 NULL 12754482747 00172 SORO FISIOLOGICO 0,9% 500 ML SI IV BS 0.0000 4.7300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 61e4786d45edfdbf19b77fb2c6ce6b9c REINALDO 12754482747 NULL 12754482747 00172 SORO FISIOLOGICO 0,9% 500 ML SI IV BS 0.0000 4.7300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 61e4786d45edfdbf19b77fb2c6ce6b9c REINALDO 12754482747 NULL 12754482747 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 61e4786d45edfdbf19b77fb2c6ce6b9c REINALDO 12754482747 NULL 12754482747 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 61e4786d45edfdbf19b77fb2c6ce6b9c REINALDO 12754482747 NULL 12754482747 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 61e4786d45edfdbf19b77fb2c6ce6b9c REINALDO 12754482747 NULL 12754482747 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 61e4786d45edfdbf19b77fb2c6ce6b9c REINALDO 12754482747 NULL 12754482747 04073 TRAMADOL 50 MG 1 ML SI IM IV AP 0.0000 4.1900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 61e4786d45edfdbf19b77fb2c6ce6b9c REINALDO 12754482747 NULL 12754482747 00487 RANITIDINA 25 MG/ML 2 ML SI IM IV AP 0.0000 0.9300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 61e4786d45edfdbf19b77fb2c6ce6b9c REINALDO 12754482747 NULL 12754482747 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.4000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 61e4786d45edfdbf19b77fb2c6ce6b9c REINALDO 12754482747 NULL 12754482747 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.4000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 61e4786d45edfdbf19b77fb2c6ce6b9c REINALDO 12754482747 NULL 12754482747 51379 SERINGA DESC 05 ML UN 0.0000 0.3800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 61e4786d45edfdbf19b77fb2c6ce6b9c REINALDO 12754482747 NULL 12754482747 51589 ESPARADRAPO 10 X 4.5 CM CM 0.0000 0.4000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 61e4786d45edfdbf19b77fb2c6ce6b9c REINALDO 12754482747 NULL 12754482747 51649 ALCOOL ETILICO 70 % ST TP ML 0.0000 0.0300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 61e4786d45edfdbf19b77fb2c6ce6b9c REINALDO 12754482747 NULL 12754482747 51649 ALCOOL ETILICO 70 % ST TP ML 0.0000 0.0300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 61e4786d45edfdbf19b77fb2c6ce6b9c REINALDO 12754482747 NULL 12754482747 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 102001 DIARIA DE APARTAMENTO 0.0000 288.8880 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4072 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4072 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4072 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4072 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4072 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4072 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 00919 ALGODAO HIDROFILO BOLINHA UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 081fdadb830fb547e83c43fabdb88372 ELZA 12377335349 NULL 12377335349 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 081fdadb830fb547e83c43fabdb88372 ELZA 12377335349 NULL 12377335349 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 081fdadb830fb547e83c43fabdb88372 ELZA 12377335349 NULL 12377335349 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 081fdadb830fb547e83c43fabdb88372 ELZA 12377335349 NULL 12377335349 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 081fdadb830fb547e83c43fabdb88372 ELZA 12377335349 NULL 12377335349 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 081fdadb830fb547e83c43fabdb88372 ELZA 12377335349 NULL 12377335349 01611 CLORETO DE POTASSIO 600 MG CA VO UN 0.0000 0.4900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 081fdadb830fb547e83c43fabdb88372 ELZA 12377335349 NULL 12377335349 01611 CLORETO DE POTASSIO 600 MG CA VO UN 0.0000 0.4900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 081fdadb830fb547e83c43fabdb88372 ELZA 12377335349 NULL 12377335349 01611 CLORETO DE POTASSIO 600 MG CA VO UN 0.0000 0.4900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 081fdadb830fb547e83c43fabdb88372 ELZA 12377335349 NULL 12377335349 02246 HIDROCORTISONA 100 MG PO IM IV FA 0.0000 5.6700 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 081fdadb830fb547e83c43fabdb88372 ELZA 12377335349 NULL 12377335349 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 081fdadb830fb547e83c43fabdb88372 ELZA 12377335349 NULL 12377335349 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1800 NULL PAGO CONFORME RELATORIO DE AUDITORIA EXTERNA ― CONTA INICIAL 1717
Glosa Min 2018-10-03 00:00:00.000000 1084117 081fdadb830fb547e83c43fabdb88372 ELZA 12377335349 NULL 12377335349 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 081fdadb830fb547e83c43fabdb88372 ELZA 12377335349 NULL 12377335349 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1800 NULL PAGO CONFORME RELATORIO DE AUDITORIA EXTERNA ― CONTA INICIAL 1717
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6860 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 51379 SERINGA DESC 05 ML UN 0.0000 0.1900 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 51379 SERINGA DESC 05 ML UN 0.0000 0.1900 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 51379 SERINGA DESC 05 ML UN 0.0000 0.1900 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 345c226bfea274af1372d41b0305a6c8 ALTINO 12720257940 NULL 12720257940 00493 BROMOPRIDA 5 MG/ML 2 ML SI IM IV AP 0.0000 2.7300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 345c226bfea274af1372d41b0305a6c8 ALTINO 12720257940 NULL 12720257940 00090 SERINGA DESC 20 ML UN 0.0000 0.5367 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 00090 SERINGA DESC 20 ML UN 0.0000 0.5400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 00090 SERINGA DESC 20 ML UN 0.0000 0.5400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 00090 SERINGA DESC 20 ML UN 0.0000 0.5400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 00090 SERINGA DESC 20 ML UN 0.0000 0.5400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 00090 SERINGA DESC 20 ML UN 0.0000 0.5400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 00090 SERINGA DESC 20 ML UN 0.0000 0.5400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 00919 ALGODAO HIDROFILO BOLINHA UN 0.0000 0.2600 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 01652 TRAMADOL 50 MG CP VO UN 0.0000 1.9300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 00184 CLORETO DE POTASSIO 10% 10 ML SI IV AP 0.0000 0.5900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6875 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6875 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 35382 COMPRESSAS DE GASES 7.5 X7,5 (11 FIOS ESTERIL) UN 0.0000 0.3000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 51588 ESPARADRAPO MICROPORE 50 X 10 CM CM 0.0000 0.5100 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 51589 ESPARADRAPO 10 X 4.5 CM CM 0.0000 0.4000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 51589 ESPARADRAPO 10 X 4.5 CM CM 0.0000 0.4000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 51589 ESPARADRAPO 10 X 4.5 CM CM 0.0000 0.4000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 610c198ec4c064687cf0524f147d3aed ROBERTO 12748814743 NULL 12748814743 16322 BENZILPENICILINA POTASSICA CRIST. 5.000.000 8.0700 8.0683 0.0017 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 610c198ec4c064687cf0524f147d3aed ROBERTO 12748814743 NULL 12748814743 16322 BENZILPENICILINA POTASSICA CRIST. 5.000.000 8.0700 8.0683 0.0017 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 610c198ec4c064687cf0524f147d3aed ROBERTO 12748814743 NULL 12748814743 16322 BENZILPENICILINA POTASSICA CRIST. 5.000.000 8.0700 8.0683 0.0017 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 51378 SERINGA DESC 03 ML UN 0.1500 0.0600 0.0900 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 51378 SERINGA DESC 03 ML UN 0.1500 0.0600 0.0900 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 51378 SERINGA DESC 03 ML UN 0.1500 0.0600 0.0900 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 51378 SERINGA DESC 03 ML UN 0.1500 0.0600 0.0900 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 03280 CLOREXIDINA 2 % ST TP ML 0.2700 0.1100 0.1600 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 03280 CLOREXIDINA 2 % ST TP ML 0.2700 0.1100 0.1600 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00091 SERINGA DESC 01 ML (INSULINA) UN 0.3100 0.1300 0.1800 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00127 LUVA DE PROCEDIMENTO UNIDADE UN 0.3300 0.1300 0.2000 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00127 LUVA DE PROCEDIMENTO UNIDADE UN 0.3300 0.1300 0.2000 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.4000 0.1600 0.2400 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.4000 0.1600 0.2400 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.4000 0.1600 0.2400 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.4000 0.1600 0.2400 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.4000 0.1600 0.2400 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.4000 0.1600 0.2400 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.4000 0.1600 0.2400 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.4000 0.1600 0.2400 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.4000 0.1600 0.2400 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.4000 0.1600 0.2400 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.4000 0.1600 0.2400 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.4000 0.1600 0.2400 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 54687 IODOPOVIDONA SD TP ML 0.4000 0.1600 0.2400 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00020010 Visita Hospitalar (Paciente Internado) 43.8000 17.1000 26.7000 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 000441 TAXA DE DELEUCOTIZAÇÃO 150.9000 58.9300 91.9700 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 01081197 e0b1f77dc9cff210f2fbead99c7ba4d4 MARCIO 12790052920 NULL 12790052920 00943 EQUIPO POLIFIX 2 VIAS UN NULL 0.0000 NULL OPME INVALIDO 2201
Glosa Min 2018-10-03 00:00:00.000000 01081197 3af14fcc4f764a77ed38b3d2e81bcc76 JOAO 12687535922 NULL 12687535922 00943 EQUIPO POLIFIX 2 VIAS UN NULL 0.0000 NULL OPME INVALIDO 2201
Glosa Min 2018-10-03 00:00:00.000000 1084117 16b1e9f62f247f02ad5cac910ee15b4e BERCHOLINA 12631612848 NULL 12631612848 04073 TRAMADOL 50 MG 1 ML SI IM IV AP 4.1900 4.0000 0.1900 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 16b1e9f62f247f02ad5cac910ee15b4e BERCHOLINA 12631612848 NULL 12631612848 04073 TRAMADOL 50 MG 1 ML SI IM IV AP 4.1900 4.0000 0.1900 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 16b1e9f62f247f02ad5cac910ee15b4e BERCHOLINA 12631612848 NULL 12631612848 04073 TRAMADOL 50 MG 1 ML SI IM IV AP 4.1900 4.0000 0.1900 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 16b1e9f62f247f02ad5cac910ee15b4e BERCHOLINA 12631612848 NULL 12631612848 04073 TRAMADOL 50 MG 1 ML SI IM IV AP 4.1900 4.0000 0.1900 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 16b1e9f62f247f02ad5cac910ee15b4e BERCHOLINA 12631612848 NULL 12631612848 04073 TRAMADOL 50 MG 1 ML SI IM IV AP 4.1900 4.0000 0.1900 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 16b1e9f62f247f02ad5cac910ee15b4e BERCHOLINA 12631612848 NULL 12631612848 04073 TRAMADOL 50 MG 1 ML SI IM IV AP 4.1900 3.9900 0.2000 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 16b1e9f62f247f02ad5cac910ee15b4e BERCHOLINA 12631612848 NULL 12631612848 00020010 Visita Hospitalar (Paciente Internado) 43.8000 41.7400 2.0600 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 16b1e9f62f247f02ad5cac910ee15b4e BERCHOLINA 12631612848 NULL 12631612848 20080 LINEZOLIDA 2 MG/ML 300 ML SI IV BS 174.9800 166.7800 8.2000 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 16b1e9f62f247f02ad5cac910ee15b4e BERCHOLINA 12631612848 NULL 12631612848 20080 LINEZOLIDA 2 MG/ML 300 ML SI IV BS 174.9800 166.7800 8.2000 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 16b1e9f62f247f02ad5cac910ee15b4e BERCHOLINA 12631612848 NULL 12631612848 20080 LINEZOLIDA 2 MG/ML 300 ML SI IV BS 174.9800 166.7800 8.2000 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 01081195 97f5f60aa3185a946dfdacc2f35b3424 MARIA 12690770218 NULL 12690770218 00010014 CONSULTA EM CONSULTORIO MEDICO 0.0000 0.0000 50.0000 GUIA DE CONSULTA NAO EXECUTADA 0622
Glosa Min 2018-10-03 00:00:00.000000 01081195 cd8240dfed3b190f93e1f35f15f53916 WANDELCY 12811021118 NULL 12811021118 00010014 CONSULTA EM CONSULTORIO MEDICO 0.0000 0.0000 50.0000 GUIA DE CONSULTA NAO EXECUTADA 0622
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 08648 ESPARADRAPO 10 X 4.5 CM CM 0.4000 0.2000 0.2000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.3500 0.0000 0.3500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 08648 ESPARADRAPO 10 X 4.5 CM CM 0.4000 0.2600 0.1400 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 32204 CLORETO DE SODIO 0,9% 10 ML SI IV AP 0.9600 0.0000 0.9600 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 02720 BOLSA COLETORA (SISTEMA ABERTO) UN 1.2800 0.6400 0.6400 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 37761 ALCOOL ETILICO 70 % ST TP ML 0.0600 0.0300 0.0300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 32204 CLORETO DE SODIO 0,9% 10 ML SI IV AP 0.9600 0.0000 0.9600 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 28959 DERSANI LC TP ML 19.4000 14.5500 4.8500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 00817 ALGODAO HIDROFILO BOLINHA UN 0.5100 0.2600 0.2500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 d17b3c5ae418d82694895a326dee545a ODILIA 12670516743 NULL 12670516743 00817 ALGODAO HIDROFILO BOLINHA UN 0.2600 0.1300 0.1300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 d17b3c5ae418d82694895a326dee545a ODILIA 12670516743 NULL 12670516743 00817 ALGODAO HIDROFILO BOLINHA UN 0.2600 0.1300 0.1300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 d17b3c5ae418d82694895a326dee545a ODILIA 12670516743 NULL 12670516743 30376 BROMETO DE IPRATROPIO 0,25MG/ML SL IN GT 0.6000 0.0000 0.6000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 00817 ALGODAO HIDROFILO BOLINHA UN 0.2600 0.1300 0.1300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 37761 ALCOOL ETILICO 70 % ST TP ML 0.0300 0.0200 0.0100 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 32891 EQUIPO POLIFIX 2ş VIAS UN 7.6500 0.0000 7.6500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 53660 EQUIPO MACRO-GOTAS FLEXIVEL C/ INJETOR LATE 4.7700 0.0000 4.7700 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 526685c1041cc1316e874a2e95e67e2e JOSE 12696604949 NULL 12696604949 57495 FILTRO BARREIRA E REGENERADOR DE CALOR E UM 24.0000 0.0000 24.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 02720 BOLSA COLETORA (SISTEMA ABERTO) UN 1.2800 0.9600 0.3200 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 02720 BOLSA COLETORA (SISTEMA ABERTO) UN 1.2800 0.9600 0.3200 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 08460 EQUIPO P/ SOLUÇOES FOTOSSENSIVEIS UN 16.4000 0.0000 16.4000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 00817 ALGODAO HIDROFILO BOLINHA UN 0.5100 0.2600 0.2500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 19160 SERINGA DESC 20 ML UN 0.5400 0.0000 0.5400 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00817 ALGODAO HIDROFILO BOLINHA UN 0.2600 0.1300 0.1300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 33219 LUVA DE PROCEDIMENTO UNIDADE UN 1.0000 0.6700 0.3300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00817 ALGODAO HIDROFILO BOLINHA UN 0.5100 0.2600 0.2500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 08664 ESPARADRAPO MICROPORE 50 X 10 CM CM 0.7700 0.2600 0.5100 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00817 ALGODAO HIDROFILO BOLINHA UN 0.5100 0.2600 0.2500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 20621 SORO GLICOSADO 5% 500 ML SI IV BS 5.1900 0.0000 5.1900 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.0000 0.8100 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00817 ALGODAO HIDROFILO BOLINHA UN 0.5100 0.2600 0.2500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 22748 LIDOCAINA 2% GE TP OU GR 7.7800 5.1900 2.5900 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 37761 ALCOOL ETILICO 70 % ST TP ML 0.0600 0.0300 0.0300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00035 ABOCATH (CATETER INTRAVENOSO) N. 14 A 22 UN 3.7700 0.0000 3.7700 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 37761 ALCOOL ETILICO 70 % ST TP ML 0.0600 0.0300 0.0300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 752c651cb4fd049e19c685f87fbe8bdc EDUARDO 12765990646 NULL 12765990646 55654 GLIMEPIRIDA 2 MG CP VO UN 1.0200 0.0000 1.0200 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 752c651cb4fd049e19c685f87fbe8bdc EDUARDO 12765990646 NULL 12765990646 00817 ALGODAO HIDROFILO BOLINHA UN 0.2600 0.1300 0.1300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 752c651cb4fd049e19c685f87fbe8bdc EDUARDO 12765990646 NULL 12765990646 25739 ELETRODO DESCARTAVEL (UTI) UN 4.6100 0.0000 4.6100 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 752c651cb4fd049e19c685f87fbe8bdc EDUARDO 12765990646 NULL 12765990646 00817 ALGODAO HIDROFILO BOLINHA UN 0.5100 0.1300 0.3800 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 752c651cb4fd049e19c685f87fbe8bdc EDUARDO 12765990646 NULL 12765990646 37761 ALCOOL ETILICO 70 % ST TP ML 0.0600 0.0200 0.0400 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 752c651cb4fd049e19c685f87fbe8bdc EDUARDO 12765990646 NULL 12765990646 53660 EQUIPO MACRO-GOTAS FLEXIVEL C/ INJETOR LATE 1.5900 0.0000 1.5900 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 37761 ALCOOL ETILICO 70 % ST TP ML 0.0300 0.0200 0.0100 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00817 ALGODAO HIDROFILO BOLINHA UN 0.2600 0.1300 0.1300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 02461 FENOTEROL 2 MG/ML 10 ML AE IN DS 2.5500 0.0000 2.5500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 345c226bfea274af1372d41b0305a6c8 ALTINO 12720257940 NULL 12720257940 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1000 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 345c226bfea274af1372d41b0305a6c8 ALTINO 12720257940 NULL 12720257940 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1000 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 345c226bfea274af1372d41b0305a6c8 ALTINO 12720257940 NULL 12720257940 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1000 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 345c226bfea274af1372d41b0305a6c8 ALTINO 12720257940 NULL 12720257940 07269 DIPIRONA 500 MG/ML 2 ML SI IV IM AP 0.6900 0.6860 0.0040 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 345c226bfea274af1372d41b0305a6c8 ALTINO 12720257940 NULL 12720257940 07269 DIPIRONA 500 MG/ML 2 ML SI IV IM AP 0.6900 0.6860 0.0040 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 345c226bfea274af1372d41b0305a6c8 ALTINO 12720257940 NULL 12720257940 07269 DIPIRONA 500 MG/ML 2 ML SI IV IM AP 0.6900 0.6860 0.0040 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 0405a686318e3fc262f105ed4be24d95 CARMELITA 12687161644 NULL 12687161644 08664 ESPARADRAPO MICROPORE 50 X 10 CM CM 0.2600 0.2500 0.0000 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 0405a686318e3fc262f105ed4be24d95 CARMELITA 12687161644 NULL 12687161644 07269 DIPIRONA 500 MG/ML 2 ML SI IV IM AP 0.6900 0.6873 0.0027 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 0405a686318e3fc262f105ed4be24d95 CARMELITA 12687161644 NULL 12687161644 07269 DIPIRONA 500 MG/ML 2 ML SI IV IM AP 0.6900 0.6873 0.0027 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 0405a686318e3fc262f105ed4be24d95 CARMELITA 12687161644 NULL 12687161644 19160 SERINGA DESC 20 ML UN 0.5400 0.5364 0.0036 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 0405a686318e3fc262f105ed4be24d95 CARMELITA 12687161644 NULL 12687161644 19160 SERINGA DESC 20 ML UN 0.5400 0.5367 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 0405a686318e3fc262f105ed4be24d95 CARMELITA 12687161644 NULL 12687161644 19160 SERINGA DESC 20 ML UN 1.0800 1.0733 0.0067 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 752c651cb4fd049e19c685f87fbe8bdc EDUARDO 12765990646 NULL 12765990646 00817 ALGODAO HIDROFILO BOLINHA UN 0.1300 0.0000 0.1300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1900 0.1850 0.0050 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 11193 CLOREXIDINA 2 % ST TP ML 0.8000 0.2700 0.5300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1900 0.1850 0.0050 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8075 0.0025 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 11193 CLOREXIDINA 2 % ST TP ML 0.8000 0.7972 0.0028 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 01081195 c0b17ac489b9ddf5461f07299a83811a HERMIONE 12812138714 NULL 12812138714 00010014 CONSULTA EM CONSULTORIO MEDICO 0.0000 35.0000 NULL ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 20672 SORO RINGER SIMPLES 500 ML SI IV BS 5.9400 5.9367 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 08648 ESPARADRAPO 10 X 4.5 CM CM 0.4000 0.0000 0.4000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 02720 BOLSA COLETORA (SISTEMA ABERTO) UN 1.2800 0.9600 0.3200 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 00817 ALGODAO HIDROFILO BOLINHA UN 0.5100 0.2600 0.2500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 02720 BOLSA COLETORA (SISTEMA ABERTO) UN 1.2800 0.9600 0.3200 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 00817 ALGODAO HIDROFILO BOLINHA UN 0.5100 0.2600 0.2500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 31d18d6607d9e742c53e748d6a55d740 CARLOS 12557779343 NULL 12557779343 08648 ESPARADRAPO 10 X 4.5 CM CM 2.0000 1.2800 0.7200 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 31d18d6607d9e742c53e748d6a55d740 CARLOS 12557779343 NULL 12557779343 33219 LUVA DE PROCEDIMENTO UNIDADE UN 3.3300 1.6700 1.6600 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 31d18d6607d9e742c53e748d6a55d740 CARLOS 12557779343 NULL 12557779343 27545 CAMPO IODOFORADO UN 96.8000 0.0000 96.8000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 31d18d6607d9e742c53e748d6a55d740 CARLOS 12557779343 NULL 12557779343 08664 ESPARADRAPO MICROPORE 50 X 10 CM CM 0.7700 0.2600 0.5100 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 31d18d6607d9e742c53e748d6a55d740 CARLOS 12557779343 NULL 12557779343 08664 ESPARADRAPO MICROPORE 50 X 10 CM CM 0.7700 0.2600 0.5100 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 00817 ALGODAO HIDROFILO BOLINHA UN 0.2600 0.1300 0.1300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 33219 LUVA DE PROCEDIMENTO UNIDADE UN 1.6700 0.6700 1.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 00817 ALGODAO HIDROFILO BOLINHA UN 0.2600 0.1300 0.1300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 33219 LUVA DE PROCEDIMENTO UNIDADE UN 1.0000 0.6700 0.3300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 31348 NIFEDIPINA 10 MG CA VO UN 0.3900 0.0000 0.3900 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 00817 ALGODAO HIDROFILO BOLINHA UN 0.2600 0.1300 0.1300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 33219 LUVA DE PROCEDIMENTO UNIDADE UN 1.0000 0.6700 0.3300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 37761 ALCOOL ETILICO 70 % ST TP ML 0.0300 0.0200 0.0100 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 00817 ALGODAO HIDROFILO BOLINHA UN 0.2600 0.1300 0.1300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 00035 ABOCATH (CATETER INTRAVENOSO) N. 14 A 22 UN 3.7700 0.0000 3.7700 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 30376 BROMETO DE IPRATROPIO 0,25MG/ML SL IN GT 0.4000 0.0000 0.4000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 02461 FENOTEROL 2 MG/ML 10 ML AE IN DS 0.2600 0.0000 0.2600 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 00817 ALGODAO HIDROFILO BOLINHA UN 0.2600 0.1300 0.1300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 02461 FENOTEROL 2 MG/ML 10 ML AE IN DS 1.5300 0.0000 1.5300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 02461 FENOTEROL 2 MG/ML 10 ML AE IN DS 0.2600 0.0000 0.2600 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 d4089ccef13567fd45b16fb0b60685fa VERA 12656425943 NULL 12656425943 33219 LUVA DE PROCEDIMENTO UNIDADE UN 1.0000 0.3300 0.6700 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 edffb7fef608512400078fdf75991573 CARLA 12728631049 NULL 12728631049 57495 FILTRO BARREIRA E REGENERADOR DE CALOR E UM 24.0000 0.0000 24.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 00817 ALGODAO HIDROFILO BOLINHA UN 0.5100 0.2600 0.2500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cd2840524be5a3f1d0939f241e24f32b MARIA 12705908340 NULL 12705908340 37761 ALCOOL ETILICO 70 % ST TP ML 0.0300 0.0200 0.0100 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cd2840524be5a3f1d0939f241e24f32b MARIA 12705908340 NULL 12705908340 00817 ALGODAO HIDROFILO BOLINHA UN 0.2600 0.1300 0.1300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cd2840524be5a3f1d0939f241e24f32b MARIA 12705908340 NULL 12705908340 37761 ALCOOL ETILICO 70 % ST TP ML 0.0300 0.0200 0.0100 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cd2840524be5a3f1d0939f241e24f32b MARIA 12705908340 NULL 12705908340 33219 LUVA DE PROCEDIMENTO UNIDADE UN 1.0000 0.6700 0.3300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cd2840524be5a3f1d0939f241e24f32b MARIA 12705908340 NULL 12705908340 37761 ALCOOL ETILICO 70 % ST TP ML 0.0300 0.0200 0.0100 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12603877940 NULL 12603877940 33219 LUVA DE PROCEDIMENTO UNIDADE UN 2.6600 0.6700 1.9900 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12603877940 NULL 12603877940 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 2.4200 2.0200 0.4000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12603877940 NULL 12603877940 37761 ALCOOL ETILICO 70 % ST TP ML 0.0300 0.0200 0.0100 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12603877940 NULL 12603877940 11193 CLOREXIDINA 2 % ST TP ML 2.1300 1.3300 0.8000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12603877940 NULL 12603877940 33219 LUVA DE PROCEDIMENTO UNIDADE UN 3.6600 0.6700 2.9900 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12603877940 NULL 12603877940 33219 LUVA DE PROCEDIMENTO UNIDADE UN 1.6700 0.6700 1.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12603877940 NULL 12603877940 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.3100 0.2100 0.1000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12603877940 NULL 12603877940 19151 SERINGA DESC 10 ML UN 1.0000 0.6700 0.3300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12603877940 NULL 12603877940 33227 LUVA CIRURGICA PAR UN 8.6900 7.2400 1.4500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12603877940 NULL 12603877940 33227 LUVA CIRURGICA PAR UN 8.6900 5.7900 2.9000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 33219 LUVA DE PROCEDIMENTO UNIDADE UN 1.0000 0.6700 0.3300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.0000 0.1000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 32204 CLORETO DE SODIO 0,9% 10 ML SI IV AP 1.9200 0.0000 1.9200 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 d4089ccef13567fd45b16fb0b60685fa VERA 12640482546 NULL 12640482546 25040014 ASSISTENCIA FISIATRICA RESPIRATORIA 0.0000 5.0300 NULL ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 818a6f2e549cc6a60aa20f9d0595eec9 ANTONIO 12565134343 NULL 12565134343 19160 SERINGA DESC 20 ML UN 0.5400 0.5374 0.0026 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 818a6f2e549cc6a60aa20f9d0595eec9 ANTONIO 12565134343 NULL 12565134343 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1767 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 a050ed50115d2a6dd0b15b99b39063da ARI 12676101147 NULL 12676101147 19160 SERINGA DESC 20 ML UN 0.5400 0.5367 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 a050ed50115d2a6dd0b15b99b39063da ARI 12676101147 NULL 12676101147 19160 SERINGA DESC 20 ML UN 0.5400 0.5367 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 a050ed50115d2a6dd0b15b99b39063da ARI 12676101147 NULL 12676101147 13404 OMEPRAZOL 40 MG + DIL. 10 ML PO IV FA 19.5800 19.5750 0.0050 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 500e4b8f04552b423f9db8f81073659f FIDELIS 12669067840 NULL 12669067840 07269 DIPIRONA 500 MG/ML 2 ML SI IV IM AP 0.6900 0.6800 0.0000 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 39df67956a358bf1eab89803158d25dd HELENA 12655863342 NULL 12655863342 07269 DIPIRONA 500 MG/ML 2 ML SI IV IM AP 0.6900 0.6800 0.0000 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 39df67956a358bf1eab89803158d25dd HELENA 12655863342 NULL 12655863342 27480 CLARITROMICINA 500 MG 30 ML PO IV FA 117.1100 117.1050 0.0050 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 9d06dbe3a8516628c3a045963dfb9c42 INAN 12623574546 NULL 12623574546 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4000 0.0000 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 9d06dbe3a8516628c3a045963dfb9c42 INAN 12623574546 NULL 12623574546 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1757 0.0043 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 4668d2494ed6c4b2d18be299efcb26a2 JOAO 12469689344 NULL 12469689344 05975 COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER 0.6000 0.3800 0.2200 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 4668d2494ed6c4b2d18be299efcb26a2 JOAO 12469689344 NULL 12469689344 17817 PROLOPA (LEVODOPA 200 MG + BENSERAZIDA 50 M 2.1200 2.1150 0.0050 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 0981c22c3928fe5329caff0f4f9420bd ZERONICE 12693863740 NULL 12693863740 33219 LUVA DE PROCEDIMENTO UNIDADE UN 0.1700 0.1600 0.0000 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 01081195 09b43710c67be7d131dc36e0a502826c ERICK 12743745311 NULL 12743745311 00010014 CONSULTA EM CONSULTORIO MEDICO 0.0000 35.0000 NULL ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 01081195 160faa4740fe4679f6fbd15ce9d84e42 GABRIELA 12743771213 NULL 12743771213 00010014 CONSULTA EM CONSULTORIO MEDICO 0.0000 35.0000 NULL ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 01081195 c08eb34e3cdcaf6866e8b44970c2170d HELENA 12732494910 NULL 12732494910 00010014 CONSULTA EM CONSULTORIO MEDICO 0.0000 35.0000 NULL ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 01081195 307aba86e3ba2f8e22e8cacd260336a4 SOLANGE 12725256015 NULL 12725256015 00010014 CONSULTA EM CONSULTORIO MEDICO 0.0000 50.0000 NULL ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 01081197 09b43710c67be7d131dc36e0a502826c ERICK 12743755120 NULL 12743755120 20010010 ECG - ELETROCARDIOGRAMA 0.0000 11.5710 NULL ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 01081197 6cc865b10b9b19e72ae4fa1d739f24ec LAURITA 12743101628 NULL 12743101628 20010010 ECG - ELETROCARDIOGRAMA 0.0000 11.5710 NULL ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1770 0.0030 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1770 0.0030 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1770 0.0030 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8072 0.0028 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8072 0.0028 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8072 0.0028 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 09733 ACETILCISTEINA 600MG PO VO SA 3.5000 3.4955 0.0045 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 09733 ACETILCISTEINA 600MG PO VO SA 3.5000 3.4955 0.0045 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 09733 ACETILCISTEINA 600MG PO VO SA 3.5000 3.4955 0.0045 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 09733 ACETILCISTEINA 600MG PO VO SA 3.5000 3.4955 0.0045 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 09733 ACETILCISTEINA 600MG PO VO SA 3.5000 3.4955 0.0045 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 08664 ESPARADRAPO MICROPORE 50 X 10 CM CM 0.7700 0.7682 0.0018 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 20672 SORO RINGER SIMPLES 500 ML SI IV BS 5.9400 5.9364 0.0036 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 58661 ENCRISE (ARGIPRESSINA) 20 U/ML 1 ML SI SC 40.2400 40.2343 0.0057 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 22896 CEFUROXIMA 750 MG + DIL. 6 ML PO IM IV FA 26.1300 26.1271 0.0029 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 42358 FUROSEMIDA 10 MG/ML 2 ML SI IM IV AP 0.6000 0.5986 0.0014 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 42358 FUROSEMIDA 10 MG/ML 2 ML SI IM IV AP 0.6000 0.5986 0.0014 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 42358 FUROSEMIDA 10 MG/ML 2 ML SI IM IV AP 0.6000 0.5986 0.0014 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4078 0.0022 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4078 0.0022 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4078 0.0022 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4078 0.0022 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4078 0.0022 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4078 0.0022 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4078 0.0022 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4078 0.0022 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4078 0.0022 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4078 0.0022 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 33227 LUVA CIRURGICA PAR UN 1.4500 1.4476 0.0024 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 33227 LUVA CIRURGICA PAR UN 1.4500 1.4476 0.0024 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 33227 LUVA CIRURGICA PAR UN 1.4500 1.4476 0.0024 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 33227 LUVA CIRURGICA PAR UN 1.4500 1.4476 0.0024 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 33227 LUVA CIRURGICA PAR UN 1.4500 1.4476 0.0024 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1034 -0.0034 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1038 -0.0038 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1038 -0.0038 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 b288bbcfb9aecab51bcb0dba62ca0059 IVONETE 12743730847 NULL 12743730847 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4067 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 b288bbcfb9aecab51bcb0dba62ca0059 IVONETE 12743730847 NULL 12743730847 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4067 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 b288bbcfb9aecab51bcb0dba62ca0059 IVONETE 12743730847 NULL 12743730847 19160 SERINGA DESC 20 ML UN 0.5400 0.5367 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 b288bbcfb9aecab51bcb0dba62ca0059 IVONETE 12743730847 NULL 12743730847 19160 SERINGA DESC 20 ML UN 0.5400 0.5367 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1900 0.1900 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1900 0.1900 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 33227 LUVA CIRURGICA PAR UN 1.4500 0.0000 1.4500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 05975 COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER 0.6000 0.3833 0.2167 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4084 0.0016 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4084 0.0016 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4084 0.0016 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4084 0.0016 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4084 0.0016 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4084 0.0016 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 2a79bf9d53875b480086bd7b8321c4f1 JOSE 12641066643 NULL 12641066643 00035 ABOCATH (CATETER INTRAVENOSO) N. 14 A 22 UN 3.7700 3.7600 0.0000 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 2a79bf9d53875b480086bd7b8321c4f1 JOSE 12641066643 NULL 12641066643 12262 ISOSSORBIDA 20 MG CP VO UN 0.2200 0.2167 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 18457 REPARIL (ESCINA + DIETILAMONIO) GL TP GR 3.7500 0.0000 3.7500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 00035 ABOCATH (CATETER INTRAVENOSO) N. 14 A 22 UN 3.7700 3.7700 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 00035 ABOCATH (CATETER INTRAVENOSO) N. 14 A 22 UN 7.5300 7.5300 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4074 0.0026 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 62aae4e8542779ba735279cbf8749d41 LAENE 12728266347 NULL 12728266347 19160 SERINGA DESC 20 ML UN 0.5400 0.5300 0.0000 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 62aae4e8542779ba735279cbf8749d41 LAENE 12728266347 NULL 12728266347 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8000 0.0000 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 19160 SERINGA DESC 20 ML UN 0.5400 0.5384 0.0016 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 32204 CLORETO DE SODIO 0,9% 10 ML SI IV AP 0.4800 0.0000 0.4800 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 32204 CLORETO DE SODIO 0,9% 10 ML SI IV AP 0.4800 0.4800 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8067 0.0033 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8067 0.0033 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 32204 CLORETO DE SODIO 0,9% 10 ML SI IV AP 0.4800 0.0000 0.4800 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 32204 CLORETO DE SODIO 0,9% 10 ML SI IV AP 0.9600 0.9600 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 05975 COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER 0.3000 0.0000 0.3000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 37761 ALCOOL ETILICO 70 % ST TP ML 0.0300 0.0000 0.0300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 37761 ALCOOL ETILICO 70 % ST TP ML 0.0300 0.0200 0.0100 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 32204 CLORETO DE SODIO 0,9% 10 ML SI IV AP 0.4800 0.0000 0.4800 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.4000 0.0000 0.4000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8080 0.0020 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 08648 ESPARADRAPO 10 X 4.5 CM CM 0.4000 0.2000 0.2000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 32204 CLORETO DE SODIO 0,9% 10 ML SI IV AP 0.4800 0.0000 0.4800 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 32204 CLORETO DE SODIO 0,9% 10 ML SI IV AP 0.4800 0.0000 0.4800 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 14460 DOMPERIDONA 10 MG CP VO UN 0.3900 0.0000 0.3900 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e715e2ae28a6229c8609756d3298bf52 MARIA 12734221144 NULL 12734221144 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1750 0.0050 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e715e2ae28a6229c8609756d3298bf52 MARIA 12734221144 NULL 12734221144 30511 CEFALOTINA 1 G FA + DIL. 10 ML FA 4.6600 4.6550 0.0050 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e715e2ae28a6229c8609756d3298bf52 MARIA 12734221144 NULL 12734221144 30511 CEFALOTINA 1 G FA + DIL. 10 ML FA 4.6600 4.6550 0.0050 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 11193 CLOREXIDINA 2 % ST TP ML 0.1300 0.0000 0.1300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 11193 CLOREXIDINA 2 % ST TP ML 0.2700 0.0000 0.2700 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 05975 COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER 0.3000 0.3836 -0.0836 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 33537 PIPERACILINA 2 G + TAZOBACTAM 250 MG 30 ML 55.3400 55.3375 0.0025 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 33537 PIPERACILINA 2 G + TAZOBACTAM 250 MG 30 ML 55.3400 55.3375 0.0025 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 42358 FUROSEMIDA 10 MG/ML 2 ML SI IM IV AP 1.2000 1.1964 0.0036 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4061 0.0039 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4061 0.0039 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4061 0.0039 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 33227 LUVA CIRURGICA PAR UN 1.4500 2.8964 -1.4464 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 33227 LUVA CIRURGICA PAR UN 1.4500 1.4477 0.0023 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 33227 LUVA CIRURGICA PAR UN 1.4500 1.4477 0.0023 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 33227 LUVA CIRURGICA PAR UN 1.4500 1.4477 0.0023 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 33227 LUVA CIRURGICA PAR UN 1.4500 1.4477 0.0023 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 33227 LUVA CIRURGICA PAR UN 1.4500 1.4477 0.0023 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 33227 LUVA CIRURGICA PAR UN 1.4500 1.4477 0.0023 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 33227 LUVA CIRURGICA PAR UN 1.4500 1.4477 0.0023 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 19135 SERINGA DESC 03 ML UN 0.3000 0.0000 0.3000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 19135 SERINGA DESC 03 ML UN 0.1500 0.0000 0.1500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 19135 SERINGA DESC 03 ML UN 0.3000 0.0000 0.3000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00817 ALGODAO HIDROFILO BOLINHA UN 0.2600 0.1300 0.1300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 19135 SERINGA DESC 03 ML UN 0.1500 0.0000 0.1500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 19135 SERINGA DESC 03 ML UN 0.1500 0.1500 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 19151 SERINGA DESC 10 ML UN 0.6700 0.6657 0.0043 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 19151 SERINGA DESC 10 ML UN 0.6700 0.6657 0.0043 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 19151 SERINGA DESC 10 ML UN 0.6700 0.6657 0.0043 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.2100 0.2057 0.0043 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1772 0.0028 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1772 0.0028 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1772 0.0028 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 08664 ESPARADRAPO MICROPORE 50 X 10 CM CM 0.7700 0.7670 0.0030 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cd2840524be5a3f1d0939f241e24f32b MARIA 12705908340 NULL 12705908340 32204 CLORETO DE SODIO 0,9% 10 ML SI IV AP 0.4800 0.4800 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cd2840524be5a3f1d0939f241e24f32b MARIA 12705908340 NULL 12705908340 32204 CLORETO DE SODIO 0,9% 10 ML SI IV AP 0.4800 0.4800 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cd2840524be5a3f1d0939f241e24f32b MARIA 12705908340 NULL 12705908340 33219 LUVA DE PROCEDIMENTO UNIDADE UN 1.0000 0.6700 0.3300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cd2840524be5a3f1d0939f241e24f32b MARIA 12705908340 NULL 12705908340 32204 CLORETO DE SODIO 0,9% 10 ML SI IV AP 0.4800 0.4800 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cd2840524be5a3f1d0939f241e24f32b MARIA 12705908340 NULL 12705908340 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1764 0.0036 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 d17b3c5ae418d82694895a326dee545a ODILIA 12670516743 NULL 12670516743 00817 ALGODAO HIDROFILO BOLINHA UN 0.1300 0.0000 0.1300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 d17b3c5ae418d82694895a326dee545a ODILIA 12670516743 NULL 12670516743 00817 ALGODAO HIDROFILO BOLINHA UN 0.1300 0.1300 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 d17b3c5ae418d82694895a326dee545a ODILIA 12670516743 NULL 12670516743 30376 BROMETO DE IPRATROPIO 0,25MG/ML SL IN GT 0.4000 0.0000 0.4000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 d17b3c5ae418d82694895a326dee545a ODILIA 12670516743 NULL 12670516743 00817 ALGODAO HIDROFILO BOLINHA UN 0.1300 0.0000 0.1300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1766 0.0034 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1766 0.0034 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 8a5ecfde671848d05ac757e0112e689c TEREZINHA 12700337042 NULL 12700337042 10626 GLICOSE 50% 10 ML SI IV AP 2.7400 2.7350 0.0050 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 8a5ecfde671848d05ac757e0112e689c TEREZINHA 12700337042 NULL 12700337042 57258 FUMARATO DE QUETIAPINA 25 MG CA VO UN 1.2500 1.2450 0.0050 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 8a5ecfde671848d05ac757e0112e689c TEREZINHA 12700337042 NULL 12700337042 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4071 0.0029 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 8a5ecfde671848d05ac757e0112e689c TEREZINHA 12700337042 NULL 12700337042 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4071 0.0029 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 8a5ecfde671848d05ac757e0112e689c TEREZINHA 12700337042 NULL 12700337042 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4071 0.0029 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 8a5ecfde671848d05ac757e0112e689c TEREZINHA 12700337042 NULL 12700337042 19160 SERINGA DESC 20 ML UN 0.5400 0.5376 0.0024 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 8a5ecfde671848d05ac757e0112e689c TEREZINHA 12700337042 NULL 12700337042 19160 SERINGA DESC 20 ML UN 0.5400 0.5376 0.0024 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 8a5ecfde671848d05ac757e0112e689c TEREZINHA 12700337042 NULL 12700337042 19160 SERINGA DESC 20 ML UN 0.5400 0.5376 0.0024 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 8a5ecfde671848d05ac757e0112e689c TEREZINHA 12700337042 NULL 12700337042 19160 SERINGA DESC 20 ML UN 0.5400 0.5376 0.0024 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 70cf23c63f890f0b61da2542c3e13a09 TIAGO 12741864645 NULL 12741864645 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1762 0.0038 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 70cf23c63f890f0b61da2542c3e13a09 TIAGO 12741864645 NULL 12741864645 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4075 0.0025 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 05975 COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER 0.0600 0.0000 0.0600 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 05975 COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER 0.3000 0.0000 0.3000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 33227 LUVA CIRURGICA PAR UN 1.4500 1.4476 0.0024 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 0111beed375944f60c7ad4a7fd4874f8 WALDIR 12746025744 NULL 12746025744 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 1.6200 1.6147 0.0053 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 0111beed375944f60c7ad4a7fd4874f8 WALDIR 12746025744 NULL 12746025744 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4076 0.0024 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 0111beed375944f60c7ad4a7fd4874f8 WALDIR 12746025744 NULL 12746025744 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4076 0.0024 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 0111beed375944f60c7ad4a7fd4874f8 WALDIR 12746025744 NULL 12746025744 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4076 0.0024 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 0111beed375944f60c7ad4a7fd4874f8 WALDIR 12746025744 NULL 12746025744 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4076 0.0024 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 0111beed375944f60c7ad4a7fd4874f8 WALDIR 12746025744 NULL 12746025744 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4076 0.0024 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 0111beed375944f60c7ad4a7fd4874f8 WALDIR 12746025744 NULL 12746025744 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4076 0.0024 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 0111beed375944f60c7ad4a7fd4874f8 WALDIR 12746025744 NULL 12746025744 19160 SERINGA DESC 20 ML UN 0.5400 0.5379 0.0021 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 0111beed375944f60c7ad4a7fd4874f8 WALDIR 12746025744 NULL 12746025744 19160 SERINGA DESC 20 ML UN 0.5400 0.5379 0.0021 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 0111beed375944f60c7ad4a7fd4874f8 WALDIR 12746025744 NULL 12746025744 19160 SERINGA DESC 20 ML UN 0.5400 0.5379 0.0021 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 37761 ALCOOL ETILICO 70 % ST TP ML 0.0600 0.0000 0.0600 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 37761 ALCOOL ETILICO 70 % ST TP ML 0.0600 0.0000 0.0600 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 00817 ALGODAO HIDROFILO BOLINHA UN 0.5100 0.2600 0.2500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 00817 ALGODAO HIDROFILO BOLINHA UN 0.2600 0.0000 0.2600 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 00817 ALGODAO HIDROFILO BOLINHA UN 0.1300 0.0000 0.1300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 27596 TIRA TESTE PARA GLICOSE UN 1.0400 1.0400 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 27596 TIRA TESTE PARA GLICOSE UN 1.0400 1.0400 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 27596 TIRA TESTE PARA GLICOSE UN 1.0400 1.0400 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 27596 TIRA TESTE PARA GLICOSE UN 1.0400 1.0400 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 27596 TIRA TESTE PARA GLICOSE UN 1.0400 1.0400 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 05975 COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER 0.3000 0.0000 0.3000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12647284040 NULL 12647284040 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4086 0.0014 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12662414945 NULL 12662414945 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4071 0.0029 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12662414945 NULL 12662414945 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4071 0.0029 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12662414945 NULL 12662414945 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4071 0.0029 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12662414945 NULL 12662414945 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4071 0.0029 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12662414945 NULL 12662414945 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4071 0.0029 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 05975 COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER 0.3000 0.0000 0.3000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 05975 COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER 0.3000 0.0000 0.3000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 05975 COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER 0.3000 0.3000 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 05975 COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER 0.6000 0.6000 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 05975 COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER 0.3000 0.3000 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 05975 COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER 0.3000 0.3000 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 33227 LUVA CIRURGICA PAR UN 1.4500 1.4476 0.0024 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 33227 LUVA CIRURGICA PAR UN 1.4500 1.4476 0.0024 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 33227 LUVA CIRURGICA PAR UN 1.4500 1.4476 0.0024 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 33227 LUVA CIRURGICA PAR UN 1.4500 1.4476 0.0024 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 33227 LUVA CIRURGICA PAR UN 1.4500 1.4476 0.0024 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 33227 LUVA CIRURGICA PAR UN 1.4500 1.4476 0.0024 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 08435 EQUIPO P/ BOMBA DE INFUSAO ENTERAL / PARENT 20.2800 0.0000 20.2800 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1770 0.0030 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1770 0.0030 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 11700 EQUIPO P/ BOMBA DE INFUSAO ENTERAL / PARENTERAL NULL 0.0000 NULL OPME INVALIDO 2201
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 51162 AGUA BIDESTILADA 10 ML SI IM IV AP NULL 0.0000 NULL OPME INVALIDO 2201
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 52941 Clorexidina Degermante 2% Fr30ml - Solução De Uso Tópico NULL 0.0000 NULL OPME INVALIDO 2201
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 34789 SONDA ASPIRAÇAO C/ VALVULA - TODAS - UTI UN 0.9400 0.9367 0.0033 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 18457 REPARIL (ESCINA + DIETILAMONIO) GL TP GR 15.0100 7.5000 7.5100 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 25798 LOSARTANA 50 MG CP VO UN 1.3300 0.0000 1.3300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 34827 TIORFAN (RACECADOTRILA) 100 MG CA VO UN 3.2000 0.0000 3.2000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 32204 CLORETO DE SODIO 0,9% 10 ML SI IV AP 0.4800 0.0000 0.4800 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.2120 -0.1120 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.2120 -0.1120 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.2120 -0.1120 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.2120 -0.1120 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.2120 -0.1120 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1060 -0.0060 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1060 -0.0060 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1060 -0.0060 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1060 -0.0060 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1060 -0.0060 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1060 -0.0060 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1060 -0.0060 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1060 -0.0060 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1060 -0.0060 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 34827 TIORFAN (RACECADOTRILA) 100 MG CA VO UN 3.2000 6.4000 -3.2000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 34827 TIORFAN (RACECADOTRILA) 100 MG CA VO UN 3.2000 3.2000 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 27596 TIRA TESTE PARA GLICOSE UN 1.0400 1.0400 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 19160 SERINGA DESC 20 ML UN 0.5400 0.5374 0.0026 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 19445 CLORETO DE POTASSIO 600 MG CA VO UN 1.4637 1.9474 -1.4574 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 07587 DRAMIN B6 DL (DIMENIDRINATO + PIRIDOXINA + 13.2771 15.4941 -13.2841 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 31585 RANITIDINA 25 MG/ML 2 ML SI IV IM AP 0.9300 1.8668 -0.9368 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 31585 RANITIDINA 25 MG/ML 2 ML SI IV IM AP 0.9300 0.9334 -0.0034 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 31585 RANITIDINA 25 MG/ML 2 ML SI IV IM AP 0.9300 0.9334 -0.0034 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 31585 RANITIDINA 25 MG/ML 2 ML SI IV IM AP 0.9300 0.9334 -0.0034 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 19151 SERINGA DESC 10 ML UN 0.6634 1.0003 -0.6703 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 19151 SERINGA DESC 10 ML UN 0.6634 1.0003 -0.6703 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 19151 SERINGA DESC 10 ML UN 0.6634 1.0003 -0.6703 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 19151 SERINGA DESC 10 ML UN 0.3300 0.6669 -0.3369 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 19151 SERINGA DESC 10 ML UN 0.3300 0.6669 -0.3369 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 19151 SERINGA DESC 10 ML UN 0.3300 0.6669 -0.3369 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 19151 SERINGA DESC 10 ML UN 0.3300 0.6669 -0.3369 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 13935 METAMUCIL (PLANTAGO OVATA) 5,85 G PO VO E 4.9236 7.3908 -4.9308 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 07269 DIPIRONA 500 MG/ML 2 ML SI IV IM AP 0.6900 0.6860 0.0040 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 37761 ALCOOL ETILICO 70 % ST TP ML 0.0631 0.0696 -0.0396 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 37761 ALCOOL ETILICO 70 % ST TP ML 0.0631 0.0695 -0.0395 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 53660 EQUIPO MACRO-GOTAS FLEXIVEL C/ INJETOR LATE 1.5900 1.5900 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 21822 TRAMADOL 50 MG 1 ML SI IM IV AP 25.1571 29.3540 -25.1640 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 11193 CLOREXIDINA 2 % ST TP ML 0.5300 0.5320 -0.0020 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 11193 CLOREXIDINA 2 % ST TP ML 0.5300 0.5320 -0.0020 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 800720d33fe0defb6121e82dd216d044 JALMO 12786952647 NULL 12786952647 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 800720d33fe0defb6121e82dd216d044 JALMO 12786952647 NULL 12786952647 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 800720d33fe0defb6121e82dd216d044 JALMO 12786952647 NULL 12786952647 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 11700 EQUIPO P/ BOMBA DE INFUSAO ENTERAL / PARENTERAL 0.0000 20.2800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4075 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 01611 CLORETO DE POTASSIO 600 MG CA VO UN 0.0000 0.0000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00172 SORO FISIOLOGICO 0,9% 500 ML SI IV BS 0.0000 4.7300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00172 SORO FISIOLOGICO 0,9% 500 ML SI IV BS 0.0000 4.7300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 02246 HIDROCORTISONA 100 MG PO IM IV FA 0.0000 2.8300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 02246 HIDROCORTISONA 100 MG PO IM IV FA 0.0000 2.8300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 02246 HIDROCORTISONA 100 MG PO IM IV FA 0.0000 2.8300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 02246 HIDROCORTISONA 100 MG PO IM IV FA 0.0000 2.8300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 02246 HIDROCORTISONA 100 MG PO IM IV FA 0.0000 2.8300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 02246 HIDROCORTISONA 100 MG PO IM IV FA 0.0000 5.6700 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 02246 HIDROCORTISONA 100 MG PO IM IV FA 0.0000 5.6700 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 26981 SORO FISIOLOGICO 0,9% 10 ML SI IV AP 0.0000 0.0000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 26981 SORO FISIOLOGICO 0,9% 10 ML SI IV AP 0.0000 0.0000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 26981 SORO FISIOLOGICO 0,9% 10 ML SI IV AP 0.0000 0.4800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 26981 SORO FISIOLOGICO 0,9% 10 ML SI IV AP 0.0000 0.9600 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 26981 SORO FISIOLOGICO 0,9% 10 ML SI IV AP 0.0000 0.9600 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 29020166 Nebulização Simples com Broncodilatador 0.0000 53.8600 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00613 CLINDAMICINA 600 MG 4 ML SI IM IV AP 0.0000 13.0800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00613 CLINDAMICINA 600 MG 4 ML SI IM IV AP 0.0000 13.0800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00613 CLINDAMICINA 600 MG 4 ML SI IM IV AP 0.0000 13.0800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00613 CLINDAMICINA 600 MG 4 ML SI IM IV AP 0.0000 13.0800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00069 SERINGA DESC 10 ML UN 0.0000 0.0000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00796 FLORATIL (SACCHAROMYCES BOULARDII) 200 MG PO VO 0.0000 4.4400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 08829 Bricanyl 0,5mg Inj. Ampola C/ 1ml 0.0000 3.5900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 09071 ACETILCISTEINA 600MG PO VO SA 0.0000 3.4950 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 09071 ACETILCISTEINA 600MG PO VO SA 0.0000 3.4950 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 09071 ACETILCISTEINA 600MG PO VO SA 0.0000 3.4950 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 09071 ACETILCISTEINA 600MG PO VO SA 0.0000 3.4950 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 09071 ACETILCISTEINA 600MG PO VO SA 0.0000 3.4950 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00091 SERINGA DESC 01 ML (INSULINA) UN 0.0000 0.3057 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00124 LUVA CIRURGICA UN 0.0000 1.4475 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00124 LUVA CIRURGICA UN 0.0000 1.4475 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4062 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4062 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4062 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4062 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 6.8124 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 01584 NEOSTIGMINA 0,5 MG/ML 1 ML SI IM IV SC AP 0.0000 0.7656 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 01584 NEOSTIGMINA 0,5 MG/ML 1 ML SI IM IV SC AP 0.0000 0.7667 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 01584 NEOSTIGMINA 0,5 MG/ML 1 ML SI IM IV SC AP 0.0000 0.7667 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 01584 NEOSTIGMINA 0,5 MG/ML 1 ML SI IM IV SC AP 0.0000 0.7667 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00170 SORO GLICOSADO 5% 250 ML SI IV BS 0.0000 3.4000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 24082 BROMOPRIDA 5 MG/ML 2 ML SI IM IV AP 0.0000 2.7300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 24082 BROMOPRIDA 5 MG/ML 2 ML SI IM IV AP 0.0000 2.7300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 24082 BROMOPRIDA 5 MG/ML 2 ML SI IM IV AP 0.0000 2.7300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 24082 BROMOPRIDA 5 MG/ML 2 ML SI IM IV AP 0.0000 2.7300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 24082 BROMOPRIDA 5 MG/ML 2 ML SI IM IV AP 0.0000 2.7300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00796 FLORATIL (SACCHAROMYCES BOULARDII) 200 MG PO VO 0.0000 4.4400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00796 FLORATIL (SACCHAROMYCES BOULARDII) 200 MG PO VO 0.0000 4.4400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00090 SERINGA DESC 20 ML UN 0.0000 0.5332 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00943 EQUIPO POLIFIX 2 VIAS UN 0.0000 2.5500 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00943 EQUIPO POLIFIX 2 VIAS UN 0.0000 2.5500 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4088 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4088 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1766 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1766 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1766 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1766 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00735 CEFTRIAXONA IV 1G + DIL. 10 ML PO IV FA 0.0000 0.0000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00090 SERINGA DESC 20 ML UN 0.0000 0.5387 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00090 SERINGA DESC 20 ML UN 0.0000 0.5387 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00090 SERINGA DESC 20 ML UN 0.0000 0.5387 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00090 SERINGA DESC 20 ML UN 0.0000 0.5387 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00090 SERINGA DESC 20 ML UN 0.0000 0.5387 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00090 SERINGA DESC 20 ML UN 0.0000 0.5387 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00090 SERINGA DESC 20 ML UN 0.0000 0.5387 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00090 SERINGA DESC 20 ML UN 0.0000 0.5387 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4070 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4070 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 00124 LUVA CIRURGICA UN 0.0000 1.4473 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 00124 LUVA CIRURGICA UN 0.0000 1.4500 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4074 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4074 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4074 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4074 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 25040014 Fisioterapia Respiratória - em Doente Clínico Internado 0.0000 10.0600 NULL EXAME NAO AUTORIZADO 2707
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 29020166 Nebulização Simples com Broncodilatador 0.0000 7.0200 NULL EXAME NAO AUTORIZADO 2707
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 00487 RANITIDINA 25 MG/ML 2 ML SI IM IV AP 0.0000 0.9300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.8073 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.8073 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.8073 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1775 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1775 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1775 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1775 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1775 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1775 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 00090 SERINGA DESC 20 ML UN 0.0000 0.5376 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 00090 SERINGA DESC 20 ML UN 0.0000 0.5376 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 00090 SERINGA DESC 20 ML UN 0.0000 0.5376 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 00124 LUVA CIRURGICA UN 0.0000 1.4476 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 25040014 Fisioterapia Respiratória - em Doente Clínico Internado 0.0000 10.0600 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 25040014 Fisioterapia Respiratória - em Doente Clínico Internado 0.0000 10.0600 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 35382 COMPRESSAS DE GASES 7.5 X7,5 (11 FIOS ESTERIL) UN 0.0000 0.3000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 35382 COMPRESSAS DE GASES 7.5 X7,5 (11 FIOS ESTERIL) UN 0.0000 0.1667 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 35382 COMPRESSAS DE GASES 7.5 X7,5 (11 FIOS ESTERIL) UN 0.0000 0.3000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 35382 COMPRESSAS DE GASES 7.5 X7,5 (11 FIOS ESTERIL) UN 0.0000 0.3000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 51584 ESPARADRAPO MICROPORE 0.0000 0.2600 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 51584 ESPARADRAPO MICROPORE 0.0000 0.2600 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 00090 SERINGA DESC 20 ML UN 0.0000 0.5366 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 00124 LUVA CIRURGICA UN 0.0000 1.4482 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 00124 LUVA CIRURGICA UN 0.0000 1.4500 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 00124 LUVA CIRURGICA UN 0.0000 1.4482 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 00128 LUVA DE PROCEDIMENTO UNIDADE UN 0.0000 1.6700 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4098 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 35382 COMPRESSAS DE GASES 7.5 X7,5 (11 FIOS ESTERIL) UN 0.0000 0.0600 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.4000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.4000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.4000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1752 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1752 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1752 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 51241 AGULHA 123X45 0.0000 0.1900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 51241 AGULHA 123X45 0.0000 0.1900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 51241 AGULHA 123X45 0.0000 0.1900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 51649 ALCOOL ETILICO 70 % ST TP ML 0.0000 0.0300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 52392 SONDA DE ASPIRAÇAO TRAQUEAL C/ VALVULA UN 0.0000 0.9352 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 52392 SONDA DE ASPIRAÇAO TRAQUEAL C/ VALVULA UN 0.0000 0.9336 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 52392 SONDA DE ASPIRAÇAO TRAQUEAL C/ VALVULA UN 0.0000 0.9352 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 52392 SONDA DE ASPIRAÇAO TRAQUEAL C/ VALVULA UN 0.0000 0.9352 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 52392 SONDA DE ASPIRAÇAO TRAQUEAL C/ VALVULA UN 0.0000 0.9400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 52392 SONDA DE ASPIRAÇAO TRAQUEAL C/ VALVULA UN 0.0000 0.9400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6874 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6874 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.3500 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 53945 ACIDO ASCORBICO 500 MG CP VO UN 0.0000 0.5900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00125 LUVA CIRURGICA UN 0.0000 1.4500 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00128 LUVA DE PROCEDIMENTO UNIDADE UN 0.0000 1.6700 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 24082 BROMOPRIDA 5 MG/ML 2 ML SI IM IV AP 0.0000 2.7300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 24082 BROMOPRIDA 5 MG/ML 2 ML SI IM IV AP 0.0000 2.7300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 24082 BROMOPRIDA 5 MG/ML 2 ML SI IM IV AP 0.0000 2.7300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ea4ad2636c25d8e3dbb569ae62db71e7 IONE 12489788840 NULL 12489788840 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.4000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ea4ad2636c25d8e3dbb569ae62db71e7 IONE 12489788840 NULL 12489788840 00737 CEFTRIAXONA IV 1G + DIL. 10 ML PO IV FA 0.0000 27.0600 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 d17b3c5ae418d82694895a326dee545a ODILIA 12670516743 NULL 12670516743 00128 LUVA DE PROCEDIMENTO UNIDADE UN 0.0000 1.6700 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 d17b3c5ae418d82694895a326dee545a ODILIA 12670516743 NULL 12670516743 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL OPME INVALIDO 2201
Glosa Min 2018-10-03 00:00:00.000000 1084117 d17b3c5ae418d82694895a326dee545a ODILIA 12670516743 NULL 12670516743 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 d17b3c5ae418d82694895a326dee545a ODILIA 12670516743 NULL 12670516743 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 d17b3c5ae418d82694895a326dee545a ODILIA 12670516743 NULL 12670516743 02197 METAMUCIL (PLANTAGO OVATA) 3,4 G PO VO EV 0.0000 2.4600 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 d17b3c5ae418d82694895a326dee545a ODILIA 12670516743 NULL 12670516743 02197 METAMUCIL (PLANTAGO OVATA) 3,4 G PO VO EV 0.0000 2.4600 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 d17b3c5ae418d82694895a326dee545a ODILIA 12670516743 NULL 12670516743 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 d17b3c5ae418d82694895a326dee545a ODILIA 12670516743 NULL 12670516743 00404 LACTULOSE 667 MG/ML XP VO ML 0.0000 6.4300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 d17b3c5ae418d82694895a326dee545a ODILIA 12670516743 NULL 12670516743 51208 SORO RINGER SIMPLES 500 ML SI IV BS 0.0000 5.9400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4074 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4074 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4074 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4074 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4074 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4074 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4074 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4072 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 01611 CLORETO DE POTASSIO 600 MG CA VO UN 0.0000 0.4867 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 02246 HIDROCORTISONA 100 MG PO IM IV FA 0.0000 2.8300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 02246 HIDROCORTISONA 100 MG PO IM IV FA 0.0000 2.8300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 02246 HIDROCORTISONA 100 MG PO IM IV FA 0.0000 2.8300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 00404 LACTULOSE 667 MG/ML XP VO ML 0.0000 0.0000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 00404 LACTULOSE 667 MG/ML XP VO ML 0.0000 6.4300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 00404 LACTULOSE 667 MG/ML XP VO ML 0.0000 6.4300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.4000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1771 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1771 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1771 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1771 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1771 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1771 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1771 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 081fdadb830fb547e83c43fabdb88372 ELZA 12377335349 NULL 12377335349 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 081fdadb830fb547e83c43fabdb88372 ELZA 12377335349 NULL 12377335349 51240 FITA ADVANTAGE P/ GLICOSE UN 0.0000 2.5900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 081fdadb830fb547e83c43fabdb88372 ELZA 12377335349 NULL 12377335349 09071 ACETILCISTEINA 600MG PO VO SA 0.0000 3.5000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 081fdadb830fb547e83c43fabdb88372 ELZA 12377335349 NULL 12377335349 09071 ACETILCISTEINA 600MG PO VO SA 0.0000 3.5000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 081fdadb830fb547e83c43fabdb88372 ELZA 12377335349 NULL 12377335349 09071 ACETILCISTEINA 600MG PO VO SA 0.0000 3.5000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 24571 CLINDAMICINA 600 MG 4 ML SI IM IV AP 0.0000 13.0800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 24571 CLINDAMICINA 600 MG 4 ML SI IM IV AP 0.0000 13.0800 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 24571 CLINDAMICINA 600 MG 4 ML SI IM IV AP 0.0000 13.0800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 24571 CLINDAMICINA 600 MG 4 ML SI IM IV AP 0.0000 13.0800 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 24571 CLINDAMICINA 600 MG 4 ML SI IM IV AP 0.0000 13.0800 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 24571 CLINDAMICINA 600 MG 4 ML SI IM IV AP 0.0000 13.0800 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 24571 CLINDAMICINA 600 MG 4 ML SI IM IV AP 0.0000 13.0800 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR APRESENTADO A MAIOR 1705
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 14191 OMEPRAZOL 20 MG CA VO UN 0.0000 0.9000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 03280 CLOREXIDINA 2 % ST TP ML 0.0000 0.5300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 03280 CLOREXIDINA 2 % ST TP ML 0.0000 0.8000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 35382 COMPRESSAS DE GASES 7.5 X7,5 (11 FIOS ESTERIL) UN 0.0000 0.6000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 00406 FUROSEMIDA 10 MG/ML 2 ML SI IM IV AP 0.0000 0.6000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 00487 RANITIDINA 25 MG/ML 2 ML SI IM IV AP 0.0000 0.9300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.4000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.8100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 51379 SERINGA DESC 05 ML UN 0.0000 0.1900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 51379 SERINGA DESC 05 ML UN 0.0000 0.1900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 51588 ESPARADRAPO MICROPORE 50 X 10 CM CM 0.0000 0.7700 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 51671 REPARIL (ESCINA + DIETILAMONIO) GL TP GR 0.0000 1.8800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 00541 AMIODARONA 200 MG CP VO UN 0.0000 0.8400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 06400 CARVEDILOL 3,125 MG CP VO UN 0.0000 0.7300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 06400 CARVEDILOL 3,125 MG CP VO UN 0.0000 0.7300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 06400 CARVEDILOL 3,125 MG CP VO UN 0.0000 0.7300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 06400 CARVEDILOL 3,125 MG CP VO UN 0.0000 0.7300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 06400 CARVEDILOL 3,125 MG CP VO UN 0.0000 0.7300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 102001 DIARIA DE APARTAMENTO 0.0000 288.8900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 11325 EQUIPO MACRO-GOTAS FLEXIVEL C/ INJETOR LATERAL UN 0.0000 1.5900 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 11325 EQUIPO MACRO-GOTAS FLEXIVEL C/ INJETOR LATERAL UN 0.0000 3.1800 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 00127 LUVA DE PROCEDIMENTO UNIDADE UN 0.0000 0.6700 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 00128 LUVA DE PROCEDIMENTO UNIDADE UN 0.0000 0.0000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 51649 ALCOOL ETILICO 70 % ST TP ML 0.0000 0.0300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 51649 ALCOOL ETILICO 70 % ST TP ML 0.0000 0.0300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 51649 ALCOOL ETILICO 70 % ST TP ML 0.0000 0.0300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 00090 SERINGA DESC 20 ML UN 0.0000 0.5400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 00090 SERINGA DESC 20 ML UN 0.0000 0.5400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 00090 SERINGA DESC 20 ML UN 0.0000 0.5400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 00090 SERINGA DESC 20 ML UN 0.0000 0.5400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 00090 SERINGA DESC 20 ML UN 0.0000 0.5400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 00919 ALGODAO HIDROFILO BOLINHA UN 0.0000 0.2600 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 00919 ALGODAO HIDROFILO BOLINHA UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 f3ad474c8c562757c4d1a959ff0961c4 DJALMA 12718763240 NULL 12718763240 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 f3ad474c8c562757c4d1a959ff0961c4 DJALMA 12718763240 NULL 12718763240 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 f3ad474c8c562757c4d1a959ff0961c4 DJALMA 12718763240 NULL 12718763240 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 f3ad474c8c562757c4d1a959ff0961c4 DJALMA 12718763240 NULL 12718763240 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 f3ad474c8c562757c4d1a959ff0961c4 DJALMA 12718763240 NULL 12718763240 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 f3ad474c8c562757c4d1a959ff0961c4 DJALMA 12718763240 NULL 12718763240 51379 SERINGA DESC 05 ML UN 0.0000 0.1900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 f3ad474c8c562757c4d1a959ff0961c4 DJALMA 12718763240 NULL 12718763240 51584 ESPARADRAPO MICROPORE 0.0000 0.2600 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 f3ad474c8c562757c4d1a959ff0961c4 DJALMA 12718763240 NULL 12718763240 00090 SERINGA DESC 20 ML UN 0.0000 0.5400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 f3ad474c8c562757c4d1a959ff0961c4 DJALMA 12718763240 NULL 12718763240 00090 SERINGA DESC 20 ML UN 0.0000 0.5400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00090 SERINGA DESC 20 ML UN 0.5400 0.2200 0.3200 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.6900 0.2700 0.4200 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.6900 0.2700 0.4200 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.6900 0.2700 0.4200 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.6900 0.2700 0.4200 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.6900 0.2700 0.4200 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.6900 0.2700 0.4200 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 01062 CATETER OXIGENIO TIPO OCULOS UN 1.0000 0.3900 0.6100 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00128 LUVA DE PROCEDIMENTO UNIDADE UN 1.0000 0.3900 0.6100 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00493 BROMOPRIDA 5 MG/ML 2 ML SI IM IV AP 2.7300 1.0600 1.6700 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00493 BROMOPRIDA 5 MG/ML 2 ML SI IM IV AP 2.7300 1.0600 1.6700 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00124 LUVA CIRURGICA UN 2.9000 1.1300 1.7700 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 51163 AGUA BIDESTILADA 250 ML 5.7900 2.2600 3.5300 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 53144 TRAMAL 5.9900 2.3300 3.6600 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 53144 TRAMAL 5.9900 2.3300 3.6600 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00404 LACTULOSE 667 MG/ML XP VO ML 6.4300 2.5100 3.9200 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00613 CLINDAMICINA 600 MG 4 ML SI IM IV AP 13.0800 5.1000 7.9800 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00613 CLINDAMICINA 600 MG 4 ML SI IM IV AP 13.0800 5.1000 7.9800 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00613 CLINDAMICINA 600 MG 4 ML SI IM IV AP 13.0800 5.1000 7.9800 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 51673 ALGINATO DE CALCIO EM HIDROGEL GL TP GR 17.2500 6.7300 10.5200 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 16b1e9f62f247f02ad5cac910ee15b4e BERCHOLINA 12631612848 NULL 12631612848 33537 PIPERACILINA 2 G + TAZOBACTAM 250 MG 30 ML 55.3400 55.3386 0.0014 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 16b1e9f62f247f02ad5cac910ee15b4e BERCHOLINA 12631612848 NULL 12631612848 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4081 0.0019 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 16b1e9f62f247f02ad5cac910ee15b4e BERCHOLINA 12631612848 NULL 12631612848 33219 LUVA DE PROCEDIMENTO UNIDADE UN 0.8370 1.0017 -0.3317 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 16b1e9f62f247f02ad5cac910ee15b4e BERCHOLINA 12631612848 NULL 12631612848 36432 HIDROCLOROTIAZIDA 25 MG CP VO UN 0.2400 0.2300 0.0100 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 16b1e9f62f247f02ad5cac910ee15b4e BERCHOLINA 12631612848 NULL 12631612848 00090 SERINGA DESC 20 ML UN 0.5400 0.5200 0.0200 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 16b1e9f62f247f02ad5cac910ee15b4e BERCHOLINA 12631612848 NULL 12631612848 00090 SERINGA DESC 20 ML UN 0.5400 0.5200 0.0200 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 16b1e9f62f247f02ad5cac910ee15b4e BERCHOLINA 12631612848 NULL 12631612848 00090 SERINGA DESC 20 ML UN 0.5400 0.5200 0.0200 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 16b1e9f62f247f02ad5cac910ee15b4e BERCHOLINA 12631612848 NULL 12631612848 00406 FUROSEMIDA 10 MG/ML 2 ML SI IM IV AP 1.2000 1.1500 0.0500 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 16b1e9f62f247f02ad5cac910ee15b4e BERCHOLINA 12631612848 NULL 12631612848 00406 FUROSEMIDA 10 MG/ML 2 ML SI IM IV AP 1.2000 1.1500 0.0500 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 16b1e9f62f247f02ad5cac910ee15b4e BERCHOLINA 12631612848 NULL 12631612848 00171 SORO FISIOLOGICO 0,9% 250 ML SI IV BS 3.9400 3.7600 0.1800 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 16b1e9f62f247f02ad5cac910ee15b4e BERCHOLINA 12631612848 NULL 12631612848 00171 SORO FISIOLOGICO 0,9% 250 ML SI IV BS 3.9400 3.7600 0.1800 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd6f8d6c53ffe9bfd3aa9590ba500cc8 ILDA 12751932542 NULL 12751932542 08648 ESPARADRAPO 10 X 4.5 CM CM 0.4000 0.2600 0.1400 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd6f8d6c53ffe9bfd3aa9590ba500cc8 ILDA 12751932542 NULL 12751932542 27545 CAMPO IODOFORADO UN 96.8000 0.0000 96.8000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd6f8d6c53ffe9bfd3aa9590ba500cc8 ILDA 12751932542 NULL 12751932542 08648 ESPARADRAPO 10 X 4.5 CM CM 0.4000 0.2600 0.1400 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 b288bbcfb9aecab51bcb0dba62ca0059 IVONETE 12743730847 NULL 12743730847 16853 PLACA P/ RECONSTRUÇAO DE ACETABULO UN 279.3000 0.0000 279.3000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 b288bbcfb9aecab51bcb0dba62ca0059 IVONETE 12743730847 NULL 12743730847 19216 SEVOFLURANO 1 ML/ML (100%) SL IN ML 301.8000 176.0500 125.7500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 00817 ALGODAO HIDROFILO BOLINHA UN 0.2600 0.1300 0.1300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 00817 ALGODAO HIDROFILO BOLINHA UN 0.2600 0.1300 0.1300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 32891 EQUIPO POLIFIX 2ş VIAS UN 2.5500 0.0000 2.5500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 05975 COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER 0.3000 0.1500 0.1500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 00817 ALGODAO HIDROFILO BOLINHA UN 0.5100 0.1300 0.3800 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 00817 ALGODAO HIDROFILO BOLINHA UN 0.5100 0.1300 0.3800 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 00817 ALGODAO HIDROFILO BOLINHA UN 0.5100 0.1300 0.3800 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 00817 ALGODAO HIDROFILO BOLINHA UN 0.5100 0.1300 0.3800 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 52302 CLOREXIDINA SL TP BU ML 0.8000 0.6000 0.2000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 37761 ALCOOL ETILICO 70 % ST TP ML 0.0600 0.0300 0.0300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 75bcd473a0dc7c7a6751499b38a4a034 JOAQUIM 12692852143 NULL 12692852143 37761 ALCOOL ETILICO 70 % ST TP ML 0.0300 0.0200 0.0100 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 75bcd473a0dc7c7a6751499b38a4a034 JOAQUIM 12692852143 NULL 12692852143 37761 ALCOOL ETILICO 70 % ST TP ML 0.0300 0.0200 0.0100 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 75bcd473a0dc7c7a6751499b38a4a034 JOAQUIM 12692852143 NULL 12692852143 37761 ALCOOL ETILICO 70 % ST TP ML 0.0300 0.0200 0.0100 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 75bcd473a0dc7c7a6751499b38a4a034 JOAQUIM 12692852143 NULL 12692852143 08648 ESPARADRAPO 10 X 4.5 CM CM 0.4000 0.1000 0.3000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 4668d2494ed6c4b2d18be299efcb26a2 JOAO 12469689344 NULL 12469689344 13757 IODOPOVIDONA SD TP ML 0.6000 0.2000 0.4000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 33219 LUVA DE PROCEDIMENTO UNIDADE UN 1.0000 0.0000 1.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 22748 LIDOCAINA 2% GE TP OU GR 2.5900 0.0000 2.5900 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 20567 SORO FISIOLOGICO 0,9% 500 ML SI IV BS 4.7300 0.0000 4.7300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 22756 LIDOCAINA 2% S/ VASO SI PE ML 0.2300 0.0000 0.2300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 53660 EQUIPO MACRO-GOTAS FLEXIVEL C/ INJETOR LATE 1.5900 0.0000 1.5900 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 19160 SERINGA DESC 20 ML UN 0.5400 0.0000 0.5400 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 05975 COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER 0.0600 0.0000 0.0600 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 19151 SERINGA DESC 10 ML UN 0.3300 0.0000 0.3300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.0000 0.1000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12603877940 NULL 12603877940 37761 ALCOOL ETILICO 70 % ST TP ML 0.0600 0.0000 0.0600 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12603877940 NULL 12603877940 55018 ALGINATO DE CALCIO EM HIDROGEL GL TP GR 58.6500 0.0000 58.6500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12603877940 NULL 12603877940 05444 CLORETO DE POTASSIO 15% 10 ML SI IV AP 0.6900 0.0000 0.6900 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12603877940 NULL 12603877940 33588 CLORETO DE SODIO 20% 10 ML SI IV AP 1.1000 0.0000 1.1000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12603877940 NULL 12603877940 53660 EQUIPO MACRO-GOTAS FLEXIVEL C/ INJETOR LATE 1.5900 0.0000 1.5900 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 00817 ALGODAO HIDROFILO BOLINHA UN 0.2600 0.1300 0.1300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 08664 ESPARADRAPO MICROPORE 50 X 10 CM CM 0.7700 0.2600 0.5100 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 37761 ALCOOL ETILICO 70 % ST TP ML 0.0300 0.0200 0.0100 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 00817 ALGODAO HIDROFILO BOLINHA UN 0.2600 0.1300 0.1300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 37761 ALCOOL ETILICO 70 % ST TP ML 0.0300 0.0200 0.0100 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 345c226bfea274af1372d41b0305a6c8 ALTINO 12720257940 NULL 12720257940 02917 ESCOPOLAMINA 10 MG + DIPIRONA 250 MG CP VO 0.4800 0.0000 0.4800 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.0000 0.1000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 33219 LUVA DE PROCEDIMENTO UNIDADE UN 1.0000 0.6700 0.3300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 37761 ALCOOL ETILICO 70 % ST TP ML 0.0300 0.0200 0.0100 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 22748 LIDOCAINA 2% GE TP OU GR 5.1900 1.3000 3.8900 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 33219 LUVA DE PROCEDIMENTO UNIDADE UN 1.0000 0.6700 0.3300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 55018 ALGINATO DE CALCIO EM HIDROGEL GL TP GR 6.9000 3.4500 3.4500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 37761 ALCOOL ETILICO 70 % ST TP ML 0.0300 0.0200 0.0100 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12558131243 NULL 12558131243 11193 CLOREXIDINA 2 % ST TP ML 0.5300 0.2700 0.2600 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12558131243 NULL 12558131243 08648 ESPARADRAPO 10 X 4.5 CM CM 0.4000 0.2600 0.1400 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12558131243 NULL 12558131243 08664 ESPARADRAPO MICROPORE 50 X 10 CM CM 0.7700 0.2600 0.5100 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 37761 ALCOOL ETILICO 70 % ST TP ML 0.0300 0.0200 0.0100 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00817 ALGODAO HIDROFILO BOLINHA UN 0.2600 0.1300 0.1300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 7c2bc8cd9bbf9ce081562a3c63fff8c9 MARTA 12647505849 NULL 12647505849 20672 SORO RINGER SIMPLES 500 ML SI IV BS 17.8100 17.8000 0.0000 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 7c2bc8cd9bbf9ce081562a3c63fff8c9 MARTA 12647505849 NULL 12647505849 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1756 0.0044 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 f65f553befc0e3bc8bd5bce5c1c6e413 NAIRLENE 12633078944 NULL 12633078944 19160 SERINGA DESC 20 ML UN 0.5400 0.5367 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 f65f553befc0e3bc8bd5bce5c1c6e413 NAIRLENE 12633078944 NULL 12633078944 19160 SERINGA DESC 20 ML UN 0.5400 0.5367 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 f65f553befc0e3bc8bd5bce5c1c6e413 NAIRLENE 12633078944 NULL 12633078944 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1760 0.0040 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 f65f553befc0e3bc8bd5bce5c1c6e413 NAIRLENE 12633078944 NULL 12633078944 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1760 0.0040 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 f65f553befc0e3bc8bd5bce5c1c6e413 NAIRLENE 12633078944 NULL 12633078944 07269 DIPIRONA 500 MG/ML 2 ML SI IV IM AP 0.6900 0.6867 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 f93cee6f501560245a8f94ffc5c6c246 ROSEDALIA 12622895145 NULL 12622895145 19160 SERINGA DESC 20 ML UN 0.5400 0.5373 0.0027 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 d4089ccef13567fd45b16fb0b60685fa VERA 12640482546 NULL 12640482546 27480 CLARITROMICINA 500 MG 30 ML PO IV FA 117.1100 117.1050 0.0050 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 d4089ccef13567fd45b16fb0b60685fa VERA 12640482546 NULL 12640482546 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1754 0.0046 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 d4089ccef13567fd45b16fb0b60685fa VERA 12640482546 NULL 12640482546 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1754 0.0046 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 d4089ccef13567fd45b16fb0b60685fa VERA 12640482546 NULL 12640482546 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1754 0.0046 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 d4089ccef13567fd45b16fb0b60685fa VERA 12640482546 NULL 12640482546 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1754 0.0046 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4074 0.0026 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4074 0.0026 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4074 0.0026 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4074 0.0026 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4074 0.0026 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 19160 SERINGA DESC 20 ML UN 0.5400 0.5372 0.0028 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 19160 SERINGA DESC 20 ML UN 0.5400 0.5372 0.0028 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 19160 SERINGA DESC 20 ML UN 0.5400 0.5372 0.0028 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 19160 SERINGA DESC 20 ML UN 0.5400 0.5372 0.0028 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 19160 SERINGA DESC 20 ML UN 0.5400 0.5372 0.0028 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 19160 SERINGA DESC 20 ML UN 0.5400 0.5372 0.0028 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 19160 SERINGA DESC 20 ML UN 0.5400 0.5372 0.0028 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1d6bbb4a00130e2e654e830fc9bae6a ALEXANDRINA 12694224940 NULL 12694224940 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4072 0.0028 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1d6bbb4a00130e2e654e830fc9bae6a ALEXANDRINA 12694224940 NULL 12694224940 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4072 0.0028 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1d6bbb4a00130e2e654e830fc9bae6a ALEXANDRINA 12694224940 NULL 12694224940 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4072 0.0028 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1d6bbb4a00130e2e654e830fc9bae6a ALEXANDRINA 12694224940 NULL 12694224940 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4072 0.0028 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1d6bbb4a00130e2e654e830fc9bae6a ALEXANDRINA 12694224940 NULL 12694224940 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4072 0.0028 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1d6bbb4a00130e2e654e830fc9bae6a ALEXANDRINA 12694224940 NULL 12694224940 19160 SERINGA DESC 20 ML UN 0.5400 0.5367 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1d6bbb4a00130e2e654e830fc9bae6a ALEXANDRINA 12694224940 NULL 12694224940 19160 SERINGA DESC 20 ML UN 0.5400 0.5367 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1d6bbb4a00130e2e654e830fc9bae6a ALEXANDRINA 12694224940 NULL 12694224940 19160 SERINGA DESC 20 ML UN 0.5400 0.5367 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1d6bbb4a00130e2e654e830fc9bae6a ALEXANDRINA 12694224940 NULL 12694224940 19160 SERINGA DESC 20 ML UN 0.5400 0.5367 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1d6bbb4a00130e2e654e830fc9bae6a ALEXANDRINA 12694224940 NULL 12694224940 19160 SERINGA DESC 20 ML UN 0.5400 0.5367 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1d6bbb4a00130e2e654e830fc9bae6a ALEXANDRINA 12694224940 NULL 12694224940 19160 SERINGA DESC 20 ML UN 0.5400 0.5367 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1d6bbb4a00130e2e654e830fc9bae6a ALEXANDRINA 12694224940 NULL 12694224940 19160 SERINGA DESC 20 ML UN 0.5400 0.5367 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1d6bbb4a00130e2e654e830fc9bae6a ALEXANDRINA 12694224940 NULL 12694224940 19160 SERINGA DESC 20 ML UN 1.0800 1.0733 0.0067 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 345c226bfea274af1372d41b0305a6c8 ALTINO 12720257940 NULL 12720257940 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1000 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 345c226bfea274af1372d41b0305a6c8 ALTINO 12720257940 NULL 12720257940 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1000 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1038 -0.0038 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1038 -0.0038 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1038 -0.0038 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1038 -0.0038 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 19160 SERINGA DESC 20 ML UN 0.5400 0.5378 0.0022 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 19160 SERINGA DESC 20 ML UN 0.5400 0.5378 0.0022 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1797 0.0003 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1797 0.0003 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1797 0.0003 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.4000 0.4045 -0.0045 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.4000 0.4045 -0.0045 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8091 0.0009 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 20567 SORO FISIOLOGICO 0,9% 500 ML SI IV BS 4.7300 4.7350 -0.0050 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 05975 COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER 0.6000 0.1500 0.4500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 05975 COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER 0.6000 0.1500 0.4500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 05975 COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER 0.3000 0.0000 0.3000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 670141098c0309ac9be3db204bdc12cf LEOSINA 12706525442 NULL 12706525442 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1767 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 670141098c0309ac9be3db204bdc12cf LEOSINA 12706525442 NULL 12706525442 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1767 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 670141098c0309ac9be3db204bdc12cf LEOSINA 12706525442 NULL 12706525442 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1767 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 670141098c0309ac9be3db204bdc12cf LEOSINA 12706525442 NULL 12706525442 02461 FENOTEROL 2 MG/ML 10 ML AE IN DS 0.4300 0.4250 0.0050 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 670141098c0309ac9be3db204bdc12cf LEOSINA 12706525442 NULL 12706525442 02461 FENOTEROL 2 MG/ML 10 ML AE IN DS 0.4300 0.4250 0.0050 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 37761 ALCOOL ETILICO 70 % ST TP ML 0.0600 0.0300 0.0300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 27480 CLARITROMICINA 500 MG 30 ML PO IV FA 117.1100 117.1050 0.0050 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1758 0.0042 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1758 0.0042 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1758 0.0042 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1758 0.0042 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1758 0.0042 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1758 0.0042 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1758 0.0042 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4072 0.0028 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4084 0.0016 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4084 0.0016 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4084 0.0016 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4084 0.0016 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4084 0.0016 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4084 0.0016 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4084 0.0016 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4084 0.0016 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4084 0.0016 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 19160 SERINGA DESC 20 ML UN 0.5400 0.5384 0.0016 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 19160 SERINGA DESC 20 ML UN 0.5400 0.5384 0.0016 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 19160 SERINGA DESC 20 ML UN 0.5400 0.5384 0.0016 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 49824 NISTATINA 100.000 UI SU VO ML 0.3000 0.3000 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 19445 CLORETO DE POTASSIO 600 MG CA VO UN 0.4900 0.4867 0.0033 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 19445 CLORETO DE POTASSIO 600 MG CA VO UN 0.4900 0.4867 0.0033 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 19445 CLORETO DE POTASSIO 600 MG CA VO UN 0.4900 0.4867 0.0033 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 19445 CLORETO DE POTASSIO 600 MG CA VO UN 0.4900 0.4867 0.0033 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 19445 CLORETO DE POTASSIO 600 MG CA VO UN 0.4900 0.4867 0.0033 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4075 0.0025 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4075 0.0025 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4075 0.0025 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 07269 DIPIRONA 500 MG/ML 2 ML SI IV IM AP 0.6900 0.6865 0.0035 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 07269 DIPIRONA 500 MG/ML 2 ML SI IV IM AP 0.6900 0.6865 0.0035 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 07269 DIPIRONA 500 MG/ML 2 ML SI IV IM AP 0.6900 0.6865 0.0035 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 19160 SERINGA DESC 20 ML UN 0.5400 0.5375 0.0025 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 19160 SERINGA DESC 20 ML UN 0.5400 0.5375 0.0025 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1769 0.0031 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1769 0.0031 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1769 0.0031 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1769 0.0031 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8073 0.0027 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8073 0.0027 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 19160 SERINGA DESC 20 ML UN 0.5400 0.5372 0.0028 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1779 0.0021 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1779 0.0021 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1779 0.0021 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1779 0.0021 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8092 0.0008 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 11193 CLOREXIDINA 2 % ST TP ML 0.5300 0.5320 -0.0020 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 08664 ESPARADRAPO MICROPORE 50 X 10 CM CM 0.2600 0.2550 0.0050 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 08664 ESPARADRAPO MICROPORE 50 X 10 CM CM 0.2600 0.2558 0.0042 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 08664 ESPARADRAPO MICROPORE 50 X 10 CM CM 0.2600 0.2558 0.0042 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 08664 ESPARADRAPO MICROPORE 50 X 10 CM CM 0.2600 0.2558 0.0042 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e2b254ce765be196b019032789d8f852 MARIA 12576216044 NULL 12576216044 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4078 0.0022 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e2b254ce765be196b019032789d8f852 MARIA 12576216044 NULL 12576216044 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4078 0.0022 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 32891 EQUIPO POLIFIX 2ş VIAS UN 2.5500 0.0000 2.5500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 08664 ESPARADRAPO MICROPORE 50 X 10 CM CM 0.7700 0.7650 0.0050 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 37761 ALCOOL ETILICO 70 % ST TP ML 0.0300 0.0000 0.0300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 d17b3c5ae418d82694895a326dee545a ODILIA 12670516743 NULL 12670516743 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1774 0.0026 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 d17b3c5ae418d82694895a326dee545a ODILIA 12670516743 NULL 12670516743 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1774 0.0026 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 d17b3c5ae418d82694895a326dee545a ODILIA 12670516743 NULL 12670516743 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1774 0.0026 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 d17b3c5ae418d82694895a326dee545a ODILIA 12670516743 NULL 12670516743 22748 LIDOCAINA 2% GE TP OU GR 5.1900 2.5900 2.6000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 6ccea6ac8c216c032723aee73a9f81c9 PRISCILA 12662249242 NULL 12662249242 07269 DIPIRONA 500 MG/ML 2 ML SI IV IM AP 0.6900 0.6864 0.0036 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 6ccea6ac8c216c032723aee73a9f81c9 PRISCILA 12662249242 NULL 12662249242 07269 DIPIRONA 500 MG/ML 2 ML SI IV IM AP 0.6900 0.6864 0.0036 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 6ccea6ac8c216c032723aee73a9f81c9 PRISCILA 12662249242 NULL 12662249242 19160 SERINGA DESC 20 ML UN 0.5400 0.5370 0.0030 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1000 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1000 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1000 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1000 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1000 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.4000 0.0000 0.4000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1766 0.0034 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 33227 LUVA CIRURGICA PAR UN 1.4500 1.4476 0.0024 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 33227 LUVA CIRURGICA PAR UN 1.4500 1.4476 0.0024 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 33227 LUVA CIRURGICA PAR UN 1.4500 1.4476 0.0024 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 33227 LUVA CIRURGICA PAR UN 1.4500 1.4476 0.0024 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 19160 SERINGA DESC 20 ML UN 0.5400 0.5384 0.0016 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 19160 SERINGA DESC 20 ML UN 0.5400 0.5384 0.0016 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 19160 SERINGA DESC 20 ML UN 0.5400 0.5384 0.0016 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 19160 SERINGA DESC 20 ML UN 0.5400 0.5384 0.0016 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1764 0.0036 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1776 0.0024 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1776 0.0024 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1776 0.0024 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1776 0.0024 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1776 0.0024 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1776 0.0024 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 53660 EQUIPO MACRO-GOTAS FLEXIVEL C/ INJETOR LATE 1.5900 1.5900 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8092 0.0008 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 6799aa3de305405ab065aad5b599765c VANIR 12700232345 NULL 12700232345 07269 DIPIRONA 500 MG/ML 2 ML SI IV IM AP 0.6900 0.6870 0.0030 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 6799aa3de305405ab065aad5b599765c VANIR 12700232345 NULL 12700232345 07269 DIPIRONA 500 MG/ML 2 ML SI IV IM AP 0.6900 0.6870 0.0030 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 6799aa3de305405ab065aad5b599765c VANIR 12700232345 NULL 12700232345 07269 DIPIRONA 500 MG/ML 2 ML SI IV IM AP 0.6900 0.6870 0.0030 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 0111beed375944f60c7ad4a7fd4874f8 WALDIR 12746025744 NULL 12746025744 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1773 0.0027 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 610c198ec4c064687cf0524f147d3aed ROBERTO 12748814743 NULL 12748814743 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4080 0.0020 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 610c198ec4c064687cf0524f147d3aed ROBERTO 12748814743 NULL 12748814743 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1767 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 610c198ec4c064687cf0524f147d3aed ROBERTO 12748814743 NULL 12748814743 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1767 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 610c198ec4c064687cf0524f147d3aed ROBERTO 12748814743 NULL 12748814743 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1767 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 610c198ec4c064687cf0524f147d3aed ROBERTO 12748814743 NULL 12748814743 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1767 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 610c198ec4c064687cf0524f147d3aed ROBERTO 12748814743 NULL 12748814743 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4091 0.0009 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 610c198ec4c064687cf0524f147d3aed ROBERTO 12748814743 NULL 12748814743 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4083 0.0017 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 610c198ec4c064687cf0524f147d3aed ROBERTO 12748814743 NULL 12748814743 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4083 0.0017 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 610c198ec4c064687cf0524f147d3aed ROBERTO 12748814743 NULL 12748814743 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4083 0.0017 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12647284040 NULL 12647284040 00817 ALGODAO HIDROFILO BOLINHA UN 0.1300 0.1200 0.0000 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12647284040 NULL 12647284040 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1750 0.0050 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12647284040 NULL 12647284040 08664 ESPARADRAPO MICROPORE 50 X 10 CM CM 0.7700 0.7667 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12647284040 NULL 12647284040 08664 ESPARADRAPO MICROPORE 50 X 10 CM CM 0.7700 0.7667 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12647284040 NULL 12647284040 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4086 0.0014 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12647284040 NULL 12647284040 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4086 0.0014 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12647284040 NULL 12647284040 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4086 0.0014 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12647284040 NULL 12647284040 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4086 0.0014 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12647284040 NULL 12647284040 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4086 0.0014 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12647284040 NULL 12647284040 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4086 0.0014 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12647284040 NULL 12647284040 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4086 0.0014 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12647284040 NULL 12647284040 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4086 0.0014 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1770 0.0030 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 75bcd473a0dc7c7a6751499b38a4a034 JOAQUIM 12692852143 NULL 12692852143 00817 ALGODAO HIDROFILO BOLINHA UN 0.3800 0.1300 0.2500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 01081197 39df67956a358bf1eab89803158d25dd HELENA 12655839525 NULL 12655839525 34010130 TOMOGRAFIA COMPUTADORIZADA DO TORAX 0.0000 280.6875 NULL ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 01081197 d976e4891c20ce18571e41a3ef37b382 SEBASTIAO 12668979425 NULL 12668979425 34010130 TOMOGRAFIA COMPUTADORIZADA DO TORAX 0.0000 280.6875 NULL ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 11193 CLOREXIDINA 2 % ST TP ML 0.5300 0.0000 0.5300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 50644 MORFINA 10 MG/ML 1 ML SI IM IV PE IT AP 2.6400 2.6400 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 33545 PIPERACILINA 4 G + TAZOBACTAM 500 MG PO IV 83.4500 83.4500 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 33545 PIPERACILINA 4 G + TAZOBACTAM 500 MG PO IV 83.4500 83.4500 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 33545 PIPERACILINA 4 G + TAZOBACTAM 500 MG PO IV 83.4500 83.4500 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 6.8145 -3.4045 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 6.8145 -3.4045 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 6.8145 -3.4045 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4072 0.0028 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4072 0.0028 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4072 0.0028 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4072 0.0028 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4072 0.0028 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4072 0.0028 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 33227 LUVA CIRURGICA PAR UN 2.9000 2.9000 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 33227 LUVA CIRURGICA PAR UN 2.9000 2.9000 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.2120 -0.1120 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.2120 -0.1120 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 19160 SERINGA DESC 20 ML UN 0.5400 0.5374 0.0026 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 19160 SERINGA DESC 20 ML UN 0.5400 0.5374 0.0026 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 19160 SERINGA DESC 20 ML UN 0.5400 0.5374 0.0026 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 19160 SERINGA DESC 20 ML UN 0.5400 0.5374 0.0026 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 19160 SERINGA DESC 20 ML UN 0.5400 0.5374 0.0026 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.4000 0.4037 -0.0037 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.4000 0.4037 -0.0037 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.4000 0.4037 -0.0037 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.4000 0.4037 -0.0037 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.4000 0.4037 -0.0037 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8073 0.0027 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8073 0.0027 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8073 0.0027 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8073 0.0027 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 33219 LUVA DE PROCEDIMENTO UNIDADE UN 1.0000 1.0050 -0.0050 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 09636 FLORATIL (SACCHAROMYCES BOULARDII) 200 MG P 4.4400 8.8851 -4.4451 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 09636 FLORATIL (SACCHAROMYCES BOULARDII) 200 MG P 4.4400 8.8851 -4.4451 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 09636 FLORATIL (SACCHAROMYCES BOULARDII) 200 MG P 4.4400 8.8851 -4.4451 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 27600 ONDANSETRONA 2 MG/ML 4 ML SI IM IV AP 81.1800 94.7100 -81.1800 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 05975 COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER 0.7739 0.8059 -0.7759 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 05975 COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER 1.3439 1.3948 -0.7948 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 05975 COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER 1.3439 1.3948 -0.7948 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 28959 DERSANI LC TP ML 5.8200 6.7900 -4.8500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 55018 ALGINATO DE CALCIO EM HIDROGEL GL TP GR 58.6500 58.6500 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 08664 ESPARADRAPO MICROPORE 50 X 10 CM CM 1.3564 1.3849 -0.8749 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 05444 CLORETO DE POTASSIO 15% 10 ML SI IV AP 17.1400 13.7200 3.4200 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1d6bbb4a00130e2e654e830fc9bae6a ALEXANDRINA 12694224940 NULL 12694224940 05274 AMOXICILINA 500 MG + CLAVULANATO 125 MG CP 3.1700 3.1667 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 03280 CLOREXIDINA 2 % ST TP ML NULL 0.0000 NULL OPME INVALIDO 2201
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 52733 SERINGA DESC 20 ML UN NULL 0.0000 NULL OPME INVALIDO 2201
Glosa Min 2018-10-03 00:00:00.000000 1084117 800720d33fe0defb6121e82dd216d044 JALMO 12786952647 NULL 12786952647 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 800720d33fe0defb6121e82dd216d044 JALMO 12786952647 NULL 12786952647 00757 CEFUROXIMA 750 MG + DIL. 6 ML PO IM IV FA 0.0000 26.1300 NULL VALOR APRESENTADO A MAIOR 1705
Glosa Min 2018-10-03 00:00:00.000000 1084117 752c651cb4fd049e19c685f87fbe8bdc EDUARDO 12765990646 NULL 12765990646 27060012 Unidade de Concentrado Hemácias 0.0000 0.0000 NULL OPME PAGO A FORNECEDOR TERCEIRIZADO 2213
Glosa Min 2018-10-03 00:00:00.000000 1084117 752c651cb4fd049e19c685f87fbe8bdc EDUARDO 12765990646 NULL 12765990646 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6875 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 752c651cb4fd049e19c685f87fbe8bdc EDUARDO 12765990646 NULL 12765990646 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6875 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 752c651cb4fd049e19c685f87fbe8bdc EDUARDO 12765990646 NULL 12765990646 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6875 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 752c651cb4fd049e19c685f87fbe8bdc EDUARDO 12765990646 NULL 12765990646 000441 TAXA DE DELEUCOTIZAÇÃO 0.0000 0.0000 NULL OPME PAGO A FORNECEDOR TERCEIRIZADO 2213
Glosa Min 2018-10-03 00:00:00.000000 1084117 752c651cb4fd049e19c685f87fbe8bdc EDUARDO 12765990646 NULL 12765990646 51208 SORO RINGER SIMPLES 500 ML SI IV BS 0.0000 5.9400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 752c651cb4fd049e19c685f87fbe8bdc EDUARDO 12765990646 NULL 12765990646 53975 Hemifumarato De Quetiapina 25mg ? Cp 0.0000 1.2450 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12558131243 NULL 12558131243 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12558131243 NULL 12558131243 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1757 NULL VALOR APRESENTADO A MAIOR 1705
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12558131243 NULL 12558131243 52010341 Hérnia Discal - Tratamento Cirúrgico 0.0000 0.0000 NULL COBRANCA DE HONORARIOS EM DUPLICIDADE 2607
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12558131243 NULL 12558131243 00657 CEFAZOLINA 1 GR + DIL. 10 ML PO IM IV FA 0.0000 8.1200 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 526685c1041cc1316e874a2e95e67e2e JOSE 12696604949 NULL 12696604949 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1760 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 526685c1041cc1316e874a2e95e67e2e JOSE 12696604949 NULL 12696604949 52733 SERINGA DESC 20 ML UN 0.0000 0.5365 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 526685c1041cc1316e874a2e95e67e2e JOSE 12696604949 NULL 12696604949 55010288 Transplante Pulmonar Total Unilateral (Doador) 0.0000 0.0000 NULL COBRANCA DE HONORARIOS EM DUPLICIDADE 2607
Glosa Min 2018-10-03 00:00:00.000000 1084117 526685c1041cc1316e874a2e95e67e2e JOSE 12696604949 NULL 12696604949 00090 SERINGA DESC 20 ML UN 0.0000 0.5367 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 526685c1041cc1316e874a2e95e67e2e JOSE 12696604949 NULL 12696604949 00090 SERINGA DESC 20 ML UN 0.0000 0.5367 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 11232 CLEXANE (ENOXAPARINA) 40 MG SI IV SC SE 0.0000 38.9400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 11232 CLEXANE (ENOXAPARINA) 40 MG SI IV SC SE 0.0000 38.9400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 1.3700 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 000501 OXIGENIO 0.0000 982.8200 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.0000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.0000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.4000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.4000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.4000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.4000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.4000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.4000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 51163 AGUA BIDESTILADA 250 ML 0.0000 5.7900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 51379 SERINGA DESC 05 ML UN 0.0000 0.1900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 51379 SERINGA DESC 05 ML UN 0.0000 0.1900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 51379 SERINGA DESC 05 ML UN 0.0000 0.1900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 51434 BECLOMETASONA 400 MCG / ML 2 ML SL IN FL 0.0000 4.4800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 51434 BECLOMETASONA 400 MCG / ML 2 ML SL IN FL 0.0000 4.4800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 51434 BECLOMETASONA 400 MCG / ML 2 ML SL IN FL 0.0000 4.4800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 51434 BECLOMETASONA 400 MCG / ML 2 ML SL IN FL 0.0000 4.4800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 51660 BROMETO DE IPRATROPIO SL IN GT 0.0000 0.0000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 51660 BROMETO DE IPRATROPIO SL IN GT 0.0000 0.0000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 51660 BROMETO DE IPRATROPIO SL IN GT 0.0000 0.0000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 51708 Dieta Hipercalorica Hiperproteica Sem Fibras 1.5 kcal 0.0000 73.4000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00091 SERINGA DESC 01 ML (INSULINA) UN 0.0000 0.3057 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 2.5500 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 35382 COMPRESSAS DE GASES 7.5 X7,5 (11 FIOS ESTERIL) UN 0.0000 0.0000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 4e13adf421809cb755e1bdd80cc4efed AGRIPINA 12385409142 NULL 12385409142 000501 OXIGENIO 0.0000 5.2000 NULL COBRANCA DE GASES INCOMPATIVEL COM O UTILIZADO/ PRESCRITO 2310
Glosa Min 2018-10-03 00:00:00.000000 1084117 4e13adf421809cb755e1bdd80cc4efed AGRIPINA 12385409142 NULL 12385409142 51649 ALCOOL ETILICO 70 % ST TP ML 0.0000 0.0300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 75bcd473a0dc7c7a6751499b38a4a034 JOAQUIM 12692852143 NULL 12692852143 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4075 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 75bcd473a0dc7c7a6751499b38a4a034 JOAQUIM 12692852143 NULL 12692852143 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4075 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 75bcd473a0dc7c7a6751499b38a4a034 JOAQUIM 12692852143 NULL 12692852143 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4075 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 75bcd473a0dc7c7a6751499b38a4a034 JOAQUIM 12692852143 NULL 12692852143 01652 TRAMADOL 50 MG CP VO UN 0.0000 1.9276 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 75bcd473a0dc7c7a6751499b38a4a034 JOAQUIM 12692852143 NULL 12692852143 01652 TRAMADOL 50 MG CP VO UN 0.0000 1.9272 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 75bcd473a0dc7c7a6751499b38a4a034 JOAQUIM 12692852143 NULL 12692852143 01652 TRAMADOL 50 MG CP VO UN 0.0000 1.9272 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 75bcd473a0dc7c7a6751499b38a4a034 JOAQUIM 12692852143 NULL 12692852143 00172 SORO FISIOLOGICO 0,9% 500 ML SI IV BS 0.0000 4.7300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 75bcd473a0dc7c7a6751499b38a4a034 JOAQUIM 12692852143 NULL 12692852143 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6850 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 75bcd473a0dc7c7a6751499b38a4a034 JOAQUIM 12692852143 NULL 12692852143 04073 TRAMADOL 50 MG 1 ML SI IM IV AP 0.0000 4.1900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 75bcd473a0dc7c7a6751499b38a4a034 JOAQUIM 12692852143 NULL 12692852143 04073 TRAMADOL 50 MG 1 ML SI IM IV AP 0.0000 4.1900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 75bcd473a0dc7c7a6751499b38a4a034 JOAQUIM 12692852143 NULL 12692852143 04073 TRAMADOL 50 MG 1 ML SI IM IV AP 0.0000 4.1900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 75bcd473a0dc7c7a6751499b38a4a034 JOAQUIM 12692852143 NULL 12692852143 04073 TRAMADOL 50 MG 1 ML SI IM IV AP 0.0000 4.1900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 75bcd473a0dc7c7a6751499b38a4a034 JOAQUIM 12692852143 NULL 12692852143 04073 TRAMADOL 50 MG 1 ML SI IM IV AP 0.0000 4.1900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00124 LUVA CIRURGICA UN 0.0000 1.4475 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 24082 BROMOPRIDA 5 MG/ML 2 ML SI IM IV AP 0.0000 2.7300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 24082 BROMOPRIDA 5 MG/ML 2 ML SI IM IV AP 0.0000 2.7300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 26981 SORO FISIOLOGICO 0,9% 10 ML SI IV AP 0.0000 0.9600 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6875 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6875 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00487 RANITIDINA 25 MG/ML 2 ML SI IM IV AP 0.0000 0.9300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00487 RANITIDINA 25 MG/ML 2 ML SI IM IV AP 0.0000 0.9300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00487 RANITIDINA 25 MG/ML 2 ML SI IM IV AP 0.0000 0.9300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 51584 ESPARADRAPO MICROPORE 0.0000 0.2560 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 51584 ESPARADRAPO MICROPORE 0.0000 0.2560 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 51584 ESPARADRAPO MICROPORE 0.0000 0.0260 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 54756 HIDANTAL 0.0000 0.1864 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00796 FLORATIL (SACCHAROMYCES BOULARDII) 200 MG PO VO 0.0000 4.4400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4088 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4088 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4088 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4088 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4088 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4088 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6872 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6872 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.0000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1766 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1766 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1766 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1766 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1766 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1766 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4070 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 22421 PIPERACILINA 2 G + TAZOBACTAM 250 MG 30 ML PO IV 0.0000 55.3400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 22421 PIPERACILINA 2 G + TAZOBACTAM 250 MG 30 ML PO IV 0.0000 55.3400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 35382 COMPRESSAS DE GASES 7.5 X7,5 (11 FIOS ESTERIL) UN 0.0000 0.3000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 51508 ENCRISE (ARGIPRESSINA) 20 U/ML 1 ML SI IM IV SC AP 0.0000 20.1200 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 51508 ENCRISE (ARGIPRESSINA) 20 U/ML 1 ML SI IM IV SC AP 0.0000 40.2400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 51584 ESPARADRAPO MICROPORE 0.0000 0.2560 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 51584 ESPARADRAPO MICROPORE 0.0000 0.2560 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cd2840524be5a3f1d0939f241e24f32b MARIA 12705908340 NULL 12705908340 00181 SULFATO DE MAGNESIO 100 MG/ML 10 ML SI IM IV 0.0000 0.9467 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cd2840524be5a3f1d0939f241e24f32b MARIA 12705908340 NULL 12705908340 00184 CLORETO DE POTASSIO 10% 10 ML SI IV AP 0.0000 0.2967 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cd2840524be5a3f1d0939f241e24f32b MARIA 12705908340 NULL 12705908340 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cd2840524be5a3f1d0939f241e24f32b MARIA 12705908340 NULL 12705908340 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cd2840524be5a3f1d0939f241e24f32b MARIA 12705908340 NULL 12705908340 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cd2840524be5a3f1d0939f241e24f32b MARIA 12705908340 NULL 12705908340 00090 SERINGA DESC 20 ML UN 0.0000 0.5367 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 51240 FITA ADVANTAGE P/ GLICOSE UN 0.0000 3.1200 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 00090 SERINGA DESC 20 ML UN 0.0000 0.5379 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 00090 SERINGA DESC 20 ML UN 0.0000 0.5379 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 00090 SERINGA DESC 20 ML UN 0.0000 0.5379 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 00091 SERINGA DESC 01 ML (INSULINA) UN 0.0000 0.6000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 01611 CLORETO DE POTASSIO 600 MG CA VO UN 0.0000 0.4867 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 01611 CLORETO DE POTASSIO 600 MG CA VO UN 0.0000 0.4867 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.8078 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.8078 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 51208 SORO RINGER SIMPLES 500 ML SI IV BS 0.0000 5.9400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 51208 SORO RINGER SIMPLES 500 ML SI IV BS 0.0000 5.9400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 51208 SORO RINGER SIMPLES 500 ML SI IV BS 0.0000 11.8800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1773 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 00090 SERINGA DESC 20 ML UN 0.0000 0.5376 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 00090 SERINGA DESC 20 ML UN 0.0000 0.5376 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 00090 SERINGA DESC 20 ML UN 0.0000 0.5376 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 00090 SERINGA DESC 20 ML UN 0.0000 0.5376 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4094 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4094 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4094 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 01496 FENITOINA 50 MG/ML 5 ML SI IM IV AP 0.0000 2.3400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 01496 FENITOINA 50 MG/ML 5 ML SI IM IV AP 0.0000 2.3400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 01496 FENITOINA 50 MG/ML 5 ML SI IM IV AP 0.0000 2.3400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 02246 HIDROCORTISONA 100 MG PO IM IV FA 0.0000 2.8300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 26981 SORO FISIOLOGICO 0,9% 10 ML SI IV AP 0.0000 0.4800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 26981 SORO FISIOLOGICO 0,9% 10 ML SI IV AP 0.0000 0.4800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 26981 SORO FISIOLOGICO 0,9% 10 ML SI IV AP 0.0000 0.4800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 26981 SORO FISIOLOGICO 0,9% 10 ML SI IV AP 0.0000 0.9600 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 26981 SORO FISIOLOGICO 0,9% 10 ML SI IV AP 0.0000 0.9600 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 26981 SORO FISIOLOGICO 0,9% 10 ML SI IV AP 0.0000 0.9600 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 09070 ACETILCISTEINA 600MG PO VO SA 0.0000 3.5000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 09070 ACETILCISTEINA 600MG PO VO SA 0.0000 3.4950 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 09070 ACETILCISTEINA 600MG PO VO SA 0.0000 3.4950 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 09070 ACETILCISTEINA 600MG PO VO SA 0.0000 3.5000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 00091 SERINGA DESC 01 ML (INSULINA) UN 0.0000 0.3000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 15f461c0ca379f375bd9f8b18fbb101a ANA 12753753845 NULL 12753753845 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR APRESENTADO A MAIOR 1705
Glosa Min 2018-10-03 00:00:00.000000 1084117 15f461c0ca379f375bd9f8b18fbb101a ANA 12753753845 NULL 12753753845 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR APRESENTADO A MAIOR 1705
Glosa Min 2018-10-03 00:00:00.000000 1084117 15f461c0ca379f375bd9f8b18fbb101a ANA 12753753845 NULL 12753753845 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR APRESENTADO A MAIOR 1705
Glosa Min 2018-10-03 00:00:00.000000 1084117 15f461c0ca379f375bd9f8b18fbb101a ANA 12753753845 NULL 12753753845 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.4000 NULL VALOR APRESENTADO A MAIOR 1705
Glosa Min 2018-10-03 00:00:00.000000 1084117 15f461c0ca379f375bd9f8b18fbb101a ANA 12753753845 NULL 12753753845 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1800 NULL VALOR APRESENTADO A MAIOR 1705
Glosa Min 2018-10-03 00:00:00.000000 1084117 15f461c0ca379f375bd9f8b18fbb101a ANA 12753753845 NULL 12753753845 52963 FILTRO DE LEUCOCITOS 0.0000 2.8829 NULL COBRANCA DE HONORARIOS EM DUPLICIDADE 2607
Glosa Min 2018-10-03 00:00:00.000000 1084117 15f461c0ca379f375bd9f8b18fbb101a ANA 12753753845 NULL 12753753845 00657 CEFAZOLINA 1 GR + DIL. 10 ML PO IM IV FA 0.0000 8.1300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00124 LUVA CIRURGICA UN 0.0000 1.4475 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00124 LUVA CIRURGICA UN 0.0000 1.4475 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00124 LUVA CIRURGICA UN 0.0000 1.4500 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4072 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4072 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4072 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4072 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4072 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4072 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4072 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4072 NULL COBRANCA DE MEDICAMENTO EM QUANTIDADE INCOMPATIVEL COM A PERMANENCIA 2107
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4072 NULL VALOR APRESENTADO A MAIOR 1705
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4072 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 01611 CLORETO DE POTASSIO 600 MG CA VO UN 0.0000 0.4870 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 01611 CLORETO DE POTASSIO 600 MG CA VO UN 0.0000 0.4870 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 01611 CLORETO DE POTASSIO 600 MG CA VO UN 0.0000 0.4870 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00184 CLORETO DE POTASSIO 10% 10 ML SI IV AP 0.0000 0.5900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 02197 METAMUCIL (PLANTAGO OVATA) 3,4 G PO VO EV 0.0000 2.4600 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 02355 AMOXICILINA 1 G + CLAVULANATO 200 MG + DIL. 10 ML 0.0000 36.4667 NULL COBRANCA DE MEDICAMENTO EM QUANTIDADE INCOMPATIVEL COM A PERMANENCIA 2107
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 02355 AMOXICILINA 1 G + CLAVULANATO 200 MG + DIL. 10 ML 0.0000 36.4667 NULL COBRANCA DE MEDICAMENTO EM QUANTIDADE INCOMPATIVEL COM A PERMANENCIA 2107
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 02355 AMOXICILINA 1 G + CLAVULANATO 200 MG + DIL. 10 ML 0.0000 36.4667 NULL COBRANCA DE MEDICAMENTO EM QUANTIDADE INCOMPATIVEL COM A PERMANENCIA 2107
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00090 SERINGA DESC 20 ML UN 0.0000 0.5357 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00090 SERINGA DESC 20 ML UN 0.0000 0.5367 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00090 SERINGA DESC 20 ML UN 0.0000 0.5367 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00090 SERINGA DESC 20 ML UN 0.0000 0.5367 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00090 SERINGA DESC 20 ML UN 0.0000 0.5367 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00090 SERINGA DESC 20 ML UN 0.0000 0.5367 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00090 SERINGA DESC 20 ML UN 0.0000 0.5367 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00090 SERINGA DESC 20 ML UN 0.0000 1.0733 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 2e6b6f291f2df9beb1fbda6028678909 ANNA 12463693448 NULL 12463693448 00184 CLORETO DE POTASSIO 10% 10 ML SI IV AP 0.0000 0.3000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 2e6b6f291f2df9beb1fbda6028678909 ANNA 12463693448 NULL 12463693448 25040014 Fisioterapia Respiratória - em Doente Clínico Internado 0.0000 5.0300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 2e6b6f291f2df9beb1fbda6028678909 ANNA 12463693448 NULL 12463693448 25040014 Fisioterapia Respiratória - em Doente Clínico Internado 0.0000 5.0300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 2e6b6f291f2df9beb1fbda6028678909 ANNA 12463693448 NULL 12463693448 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 2e6b6f291f2df9beb1fbda6028678909 ANNA 12463693448 NULL 12463693448 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 2e6b6f291f2df9beb1fbda6028678909 ANNA 12463693448 NULL 12463693448 51241 AGULHA 123X45 0.0000 0.1900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 2e6b6f291f2df9beb1fbda6028678909 ANNA 12463693448 NULL 12463693448 09070 ACETILCISTEINA 600MG PO VO SA 0.0000 3.5000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 2e6b6f291f2df9beb1fbda6028678909 ANNA 12463693448 NULL 12463693448 09070 ACETILCISTEINA 600MG PO VO SA 0.0000 3.5000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 31d18d6607d9e742c53e748d6a55d740 CARLOS 12557779343 NULL 12557779343 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00124 LUVA CIRURGICA UN 0.0000 1.4478 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00124 LUVA CIRURGICA UN 0.0000 1.4500 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00124 LUVA CIRURGICA UN 0.0000 1.4478 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6867 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6871 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6871 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6871 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 35382 COMPRESSAS DE GASES 7.5 X7,5 (11 FIOS ESTERIL) UN 0.0000 0.6000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00487 RANITIDINA 25 MG/ML 2 ML SI IM IV AP 0.0000 0.9300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00487 RANITIDINA 25 MG/ML 2 ML SI IM IV AP 0.0000 0.9300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.4000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.4000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.4000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 1.6200 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1776 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1776 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 51649 ALCOOL ETILICO 70 % ST TP ML 0.0000 0.0300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 54157 EQUIPO P/ DIETA ENTERAL UN 0.0000 1.7000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00090 SERINGA DESC 20 ML UN 0.0000 0.5375 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00090 SERINGA DESC 20 ML UN 0.0000 0.5375 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00090 SERINGA DESC 20 ML UN 0.0000 0.5400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00090 SERINGA DESC 20 ML UN 0.0000 1.6100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.8074 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.8074 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.8074 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.8074 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.8074 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1775 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1775 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1775 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1775 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 51671 REPARIL (ESCINA + DIETILAMONIO) GL TP GR 0.0000 0.0000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 00090 SERINGA DESC 20 ML UN 0.0000 0.5375 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 00090 SERINGA DESC 20 ML UN 0.0000 0.5375 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 00090 SERINGA DESC 20 ML UN 0.0000 0.5375 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 00090 SERINGA DESC 20 ML UN 0.0000 0.5375 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 00090 SERINGA DESC 20 ML UN 0.0000 0.5375 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 00090 SERINGA DESC 20 ML UN 0.0000 0.5375 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 00090 SERINGA DESC 20 ML UN 0.0000 0.5375 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 00090 SERINGA DESC 20 ML UN 0.0000 0.5375 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 00098 ABOCATH N 14 A 22 UN 0.0000 3.7700 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd6f8d6c53ffe9bfd3aa9590ba500cc8 ILDA 12751932542 NULL 12751932542 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 13.6200 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd6f8d6c53ffe9bfd3aa9590ba500cc8 ILDA 12751932542 NULL 12751932542 00172 SORO FISIOLOGICO 0,9% 500 ML SI IV BS 0.0000 14.2000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd6f8d6c53ffe9bfd3aa9590ba500cc8 ILDA 12751932542 NULL 12751932542 55279 TRAMADOL 50 MG 1 ML SI IM IV AP 0.0000 12.5800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd6f8d6c53ffe9bfd3aa9590ba500cc8 ILDA 12751932542 NULL 12751932542 00558 LAMINA BISTURI N 20, 22 E 24 UN 0.0000 0.6700 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 00111 ABOCATH N 14 A 22 UN 0.0000 3.7700 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 00128 LUVA DE PROCEDIMENTO UNIDADE UN 0.0000 1.6700 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 01691 NISTATINA 100.000 UI/ML SU VO ML 0.0000 0.2950 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 20691 HIDROCORTISONA 100 MG PO IM IV FA 0.0000 2.8300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 20691 HIDROCORTISONA 100 MG PO IM IV FA 0.0000 2.8300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 20691 HIDROCORTISONA 100 MG PO IM IV FA 0.0000 2.8300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 20691 HIDROCORTISONA 100 MG PO IM IV FA 0.0000 2.8300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 26981 SORO FISIOLOGICO 0,9% 10 ML SI IV AP 0.0000 0.1400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 26981 SORO FISIOLOGICO 0,9% 10 ML SI IV AP 0.0000 0.1400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 26981 SORO FISIOLOGICO 0,9% 10 ML SI IV AP 0.0000 0.1400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 29020166 Nebulização Simples com Broncodilatador 0.0000 1.1700 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 29020166 Nebulização Simples com Broncodilatador 0.0000 4.6800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1765 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1765 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 51241 AGULHA 123X45 0.0000 0.1900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 51241 AGULHA 123X45 0.0000 0.1900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 00090 SERINGA DESC 20 ML UN 0.0000 0.5400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 00090 SERINGA DESC 20 ML UN 0.0000 0.5373 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 00090 SERINGA DESC 20 ML UN 0.0000 0.5373 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 00090 SERINGA DESC 20 ML UN 0.0000 0.5373 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 00943 EQUIPO POLIFIX 2 VIAS UN 0.0000 2.5500 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 61e4786d45edfdbf19b77fb2c6ce6b9c REINALDO 12754482747 NULL 12754482747 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 61e4786d45edfdbf19b77fb2c6ce6b9c REINALDO 12754482747 NULL 12754482747 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 61e4786d45edfdbf19b77fb2c6ce6b9c REINALDO 12754482747 NULL 12754482747 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 61e4786d45edfdbf19b77fb2c6ce6b9c REINALDO 12754482747 NULL 12754482747 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 61e4786d45edfdbf19b77fb2c6ce6b9c REINALDO 12754482747 NULL 12754482747 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 61e4786d45edfdbf19b77fb2c6ce6b9c REINALDO 12754482747 NULL 12754482747 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 61e4786d45edfdbf19b77fb2c6ce6b9c REINALDO 12754482747 NULL 12754482747 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 61e4786d45edfdbf19b77fb2c6ce6b9c REINALDO 12754482747 NULL 12754482747 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 61e4786d45edfdbf19b77fb2c6ce6b9c REINALDO 12754482747 NULL 12754482747 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 61e4786d45edfdbf19b77fb2c6ce6b9c REINALDO 12754482747 NULL 12754482747 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 61e4786d45edfdbf19b77fb2c6ce6b9c REINALDO 12754482747 NULL 12754482747 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 61e4786d45edfdbf19b77fb2c6ce6b9c REINALDO 12754482747 NULL 12754482747 00037 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.3800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 61e4786d45edfdbf19b77fb2c6ce6b9c REINALDO 12754482747 NULL 12754482747 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 61e4786d45edfdbf19b77fb2c6ce6b9c REINALDO 12754482747 NULL 12754482747 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 61e4786d45edfdbf19b77fb2c6ce6b9c REINALDO 12754482747 NULL 12754482747 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 61e4786d45edfdbf19b77fb2c6ce6b9c REINALDO 12754482747 NULL 12754482747 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 102001 DIARIA DE APARTAMENTO 0.0000 288.8900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 102001 DIARIA DE APARTAMENTO 0.0000 288.8900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4072 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4072 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4072 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4072 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4072 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 081fdadb830fb547e83c43fabdb88372 ELZA 12377335349 NULL 12377335349 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 081fdadb830fb547e83c43fabdb88372 ELZA 12377335349 NULL 12377335349 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 081fdadb830fb547e83c43fabdb88372 ELZA 12377335349 NULL 12377335349 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 081fdadb830fb547e83c43fabdb88372 ELZA 12377335349 NULL 12377335349 01611 CLORETO DE POTASSIO 600 MG CA VO UN 0.0000 0.4900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 081fdadb830fb547e83c43fabdb88372 ELZA 12377335349 NULL 12377335349 01611 CLORETO DE POTASSIO 600 MG CA VO UN 0.0000 0.4900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 081fdadb830fb547e83c43fabdb88372 ELZA 12377335349 NULL 12377335349 01611 CLORETO DE POTASSIO 600 MG CA VO UN 0.0000 0.4900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 081fdadb830fb547e83c43fabdb88372 ELZA 12377335349 NULL 12377335349 02246 HIDROCORTISONA 100 MG PO IM IV FA 0.0000 2.8300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 081fdadb830fb547e83c43fabdb88372 ELZA 12377335349 NULL 12377335349 02246 HIDROCORTISONA 100 MG PO IM IV FA 0.0000 5.6700 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6860 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1800 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 51379 SERINGA DESC 05 ML UN 0.0000 0.1900 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 51379 SERINGA DESC 05 ML UN 0.0000 0.1900 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 51379 SERINGA DESC 05 ML UN 0.0000 0.1900 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 51379 SERINGA DESC 05 ML UN 0.0000 0.1900 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 51379 SERINGA DESC 05 ML UN 0.0000 0.1900 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 51379 SERINGA DESC 05 ML UN 0.0000 0.1900 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 51379 SERINGA DESC 05 ML UN 0.0000 0.1900 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 51379 SERINGA DESC 05 ML UN 0.0000 0.1900 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 51379 SERINGA DESC 05 ML UN 0.0000 0.1900 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 51379 SERINGA DESC 05 ML UN 0.0000 0.1900 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 51379 SERINGA DESC 05 ML UN 0.0000 0.1900 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 345c226bfea274af1372d41b0305a6c8 ALTINO 12720257940 NULL 12720257940 04073 TRAMADOL 50 MG 1 ML SI IM IV AP 0.0000 4.1900 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 345c226bfea274af1372d41b0305a6c8 ALTINO 12720257940 NULL 12720257940 00493 BROMOPRIDA 5 MG/ML 2 ML SI IM IV AP 0.0000 0.0000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 345c226bfea274af1372d41b0305a6c8 ALTINO 12720257940 NULL 12720257940 00090 SERINGA DESC 20 ML UN 0.0000 0.5367 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 345c226bfea274af1372d41b0305a6c8 ALTINO 12720257940 NULL 12720257940 00090 SERINGA DESC 20 ML UN 0.0000 0.5367 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 01062 CATETER OXIGENIO TIPO OCULOS UN 0.0000 1.0000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 01062 CATETER OXIGENIO TIPO OCULOS UN 0.0000 1.0000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 00090 SERINGA DESC 20 ML UN 0.0000 0.5400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 00090 SERINGA DESC 20 ML UN 0.0000 0.5400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 01652 TRAMADOL 50 MG CP VO UN 0.0000 1.9300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6875 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 35382 COMPRESSAS DE GASES 7.5 X7,5 (11 FIOS ESTERIL) UN 0.0000 0.3000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 35382 COMPRESSAS DE GASES 7.5 X7,5 (11 FIOS ESTERIL) UN 0.0000 0.3000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 35382 COMPRESSAS DE GASES 7.5 X7,5 (11 FIOS ESTERIL) UN 0.0000 0.3000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3fb5c891f31bb9efcb05395066127c52 ALAIDE 12636273441 NULL 12636273441 26981 SORO FISIOLOGICO 0,9% 10 ML SI IV AP 0.0000 0.6000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 610c198ec4c064687cf0524f147d3aed ROBERTO 12748814743 NULL 12748814743 16322 BENZILPENICILINA POTASSICA CRIST. 5.000.000 8.0700 8.0683 0.0017 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 51378 SERINGA DESC 03 ML UN 0.1500 0.0600 0.0900 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 54678 HUMULIN 0.2500 0.1000 0.1500 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00127 LUVA DE PROCEDIMENTO UNIDADE UN 0.3300 0.1300 0.2000 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.4000 0.1600 0.2400 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.4000 0.1600 0.2400 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.4000 0.1600 0.2400 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.4000 0.1600 0.2400 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.4000 0.1600 0.2400 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.4000 0.1600 0.2400 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.4000 0.1600 0.2400 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.4000 0.1600 0.2400 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.4000 0.1600 0.2400 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.4000 0.1600 0.2400 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 54687 IODOPOVIDONA SD TP ML 0.4000 0.1600 0.2400 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 14191 OMEPRAZOL 20 MG CA VO UN 0.4500 0.1800 0.2700 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00090 SERINGA DESC 20 ML UN 0.5400 0.2200 0.3200 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 07802 PIPERACILINA 4 G + TAZOBACTAM 500 MG PO IV FA 83.4500 32.5900 50.8600 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 07802 PIPERACILINA 4 G + TAZOBACTAM 500 MG PO IV FA 83.4500 32.5900 50.8600 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 01081197 edcdbaa61bbaa91565bc29f993979fda JOHN 12767485129 NULL 12767485129 32020040 COLUNA DORSAL AP LATERAL 0.0000 24.0850 NULL ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 01081197 6d2e0c731641497ed5076fae7729f241 MARI 12763893222 NULL 12763893222 201001 TAXA DE SALA PORTE 0 NULL 0.0000 NULL OPME INVALIDO 2201
Glosa Min 2018-10-03 00:00:00.000000 01081197 2f6e33ac8c03dabedfcad2337f7d3f03 LORIVAL 12661325027 NULL 12661325027 201001 TAXA DE SALA PORTE 0 NULL 0.0000 NULL OPME INVALIDO 2201
Glosa Min 2018-10-03 00:00:00.000000 1084117 16b1e9f62f247f02ad5cac910ee15b4e BERCHOLINA 12631612848 NULL 12631612848 55328 TRAMADOL 100 MG 2 ML SI IM IV AP 17.9800 17.1300 0.8500 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 16b1e9f62f247f02ad5cac910ee15b4e BERCHOLINA 12631612848 NULL 12631612848 22421 PIPERACILINA 2 G + TAZOBACTAM 250 MG 30 ML PO IV 55.3400 52.7400 2.6000 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 01081197 71f5440171ef97870d290cb22b5aa301 ITAMAR 12750251527 NULL 12750251527 20010010 ECG - ELETROCARDIOGRAMA 0.0000 11.5710 NULL ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 01081195 6650c57ea7c065d5dbd2a475d4a9212d JUCELINA 12816050014 NULL 12816050014 00010014 CONSULTA EM CONSULTORIO MEDICO 0.0000 50.0000 NULL ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 32204 CLORETO DE SODIO 0,9% 10 ML SI IV AP 0.4800 0.0000 0.4800 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 37761 ALCOOL ETILICO 70 % ST TP ML 0.0600 0.0300 0.0300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 08648 ESPARADRAPO 10 X 4.5 CM CM 0.4000 0.2000 0.2000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 32204 CLORETO DE SODIO 0,9% 10 ML SI IV AP 0.9600 0.0000 0.9600 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 37761 ALCOOL ETILICO 70 % ST TP ML 0.0600 0.0300 0.0300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 00485 AGUA BIDESTILADA 500 ML SI IM IV BS 6.4300 0.0000 6.4300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 32204 CLORETO DE SODIO 0,9% 10 ML SI IV AP 0.9600 0.0000 0.9600 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 00817 ALGODAO HIDROFILO BOLINHA UN 0.5100 0.2600 0.2500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 02720 BOLSA COLETORA (SISTEMA ABERTO) UN 1.2800 0.6400 0.6400 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.3500 0.0000 0.3500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 d17b3c5ae418d82694895a326dee545a ODILIA 12670516743 NULL 12670516743 05975 COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER 0.0300 0.0000 0.0300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 d17b3c5ae418d82694895a326dee545a ODILIA 12670516743 NULL 12670516743 30376 BROMETO DE IPRATROPIO 0,25MG/ML SL IN GT 0.6000 0.0000 0.6000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 d17b3c5ae418d82694895a326dee545a ODILIA 12670516743 NULL 12670516743 08648 ESPARADRAPO 10 X 4.5 CM CM 0.4000 0.2000 0.2000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 33219 LUVA DE PROCEDIMENTO UNIDADE UN 1.0000 0.6700 0.3300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 33219 LUVA DE PROCEDIMENTO UNIDADE UN 1.0000 0.6700 0.3300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 00817 ALGODAO HIDROFILO BOLINHA UN 0.5100 0.1300 0.3800 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 00817 ALGODAO HIDROFILO BOLINHA UN 0.5100 0.2600 0.2500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 37761 ALCOOL ETILICO 70 % ST TP ML 0.0600 0.0300 0.0300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 13757 IODOPOVIDONA SD TP ML 0.3000 0.2000 0.1000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 08648 ESPARADRAPO 10 X 4.5 CM CM 0.4000 0.0000 0.4000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 00817 ALGODAO HIDROFILO BOLINHA UN 0.5100 0.2600 0.2500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 14370 FIO MONONYLON 3-0 C/ AGULHA 2,4 3/8 163T E 13.3700 6.6900 6.6800 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00817 ALGODAO HIDROFILO BOLINHA UN 0.2600 0.1300 0.1300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 37761 ALCOOL ETILICO 70 % ST TP ML 0.0300 0.0200 0.0100 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 19151 SERINGA DESC 10 ML UN 0.3300 0.0000 0.3300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 08648 ESPARADRAPO 10 X 4.5 CM CM 0.4000 0.2000 0.2000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 37761 ALCOOL ETILICO 70 % ST TP ML 0.0600 0.0300 0.0300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 02720 BOLSA COLETORA (SISTEMA ABERTO) UN 1.2800 0.6400 0.6400 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00817 ALGODAO HIDROFILO BOLINHA UN 0.5100 0.1300 0.3800 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 52353 ABAIXADOR DE LINGUA UN 0.0500 0.0300 0.0200 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00817 ALGODAO HIDROFILO BOLINHA UN 0.5100 0.2600 0.2500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00817 ALGODAO HIDROFILO BOLINHA UN 0.5100 0.2600 0.2500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 37761 ALCOOL ETILICO 70 % ST TP ML 0.0600 0.0300 0.0300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 752c651cb4fd049e19c685f87fbe8bdc EDUARDO 12765990646 NULL 12765990646 37761 ALCOOL ETILICO 70 % ST TP ML 0.0600 0.0200 0.0400 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 752c651cb4fd049e19c685f87fbe8bdc EDUARDO 12765990646 NULL 12765990646 37761 ALCOOL ETILICO 70 % ST TP ML 0.0600 0.0200 0.0400 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 05975 COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER 0.3000 0.0000 0.3000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 08648 ESPARADRAPO 10 X 4.5 CM CM 0.4000 0.2000 0.2000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 345c226bfea274af1372d41b0305a6c8 ALTINO 12720257940 NULL 12720257940 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1000 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 345c226bfea274af1372d41b0305a6c8 ALTINO 12720257940 NULL 12720257940 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1000 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 345c226bfea274af1372d41b0305a6c8 ALTINO 12720257940 NULL 12720257940 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1000 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 345c226bfea274af1372d41b0305a6c8 ALTINO 12720257940 NULL 12720257940 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1000 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 345c226bfea274af1372d41b0305a6c8 ALTINO 12720257940 NULL 12720257940 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1000 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 345c226bfea274af1372d41b0305a6c8 ALTINO 12720257940 NULL 12720257940 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1000 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 345c226bfea274af1372d41b0305a6c8 ALTINO 12720257940 NULL 12720257940 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1750 0.0050 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 345c226bfea274af1372d41b0305a6c8 ALTINO 12720257940 NULL 12720257940 07269 DIPIRONA 500 MG/ML 2 ML SI IV IM AP 0.6900 0.6860 0.0040 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 345c226bfea274af1372d41b0305a6c8 ALTINO 12720257940 NULL 12720257940 07269 DIPIRONA 500 MG/ML 2 ML SI IV IM AP 0.6900 0.6860 0.0040 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 345c226bfea274af1372d41b0305a6c8 ALTINO 12720257940 NULL 12720257940 13404 OMEPRAZOL 40 MG + DIL. 10 ML PO IV FA 19.5800 19.5750 0.0050 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 31d18d6607d9e742c53e748d6a55d740 CARLOS 12557779343 NULL 12557779343 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1760 0.0040 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 31d18d6607d9e742c53e748d6a55d740 CARLOS 12557779343 NULL 12557779343 07269 DIPIRONA 500 MG/ML 2 ML SI IV IM AP 0.6900 0.6860 0.0040 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 0405a686318e3fc262f105ed4be24d95 CARMELITA 12687161644 NULL 12687161644 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 5.1900 5.1800 0.0000 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 0405a686318e3fc262f105ed4be24d95 CARMELITA 12687161644 NULL 12687161644 19151 SERINGA DESC 10 ML UN 0.6700 0.6650 0.0050 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 0405a686318e3fc262f105ed4be24d95 CARMELITA 12687161644 NULL 12687161644 07269 DIPIRONA 500 MG/ML 2 ML SI IV IM AP 0.6900 0.6873 0.0027 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 0405a686318e3fc262f105ed4be24d95 CARMELITA 12687161644 NULL 12687161644 07269 DIPIRONA 500 MG/ML 2 ML SI IV IM AP 0.6900 0.6873 0.0027 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 0405a686318e3fc262f105ed4be24d95 CARMELITA 12687161644 NULL 12687161644 19160 SERINGA DESC 20 ML UN 0.5400 0.5367 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 ea6abb4182a48f0934f3e9eb5affa056 DILVA 12697455440 NULL 12697455440 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1750 0.0050 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 ea6abb4182a48f0934f3e9eb5affa056 DILVA 12697455440 NULL 12697455440 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1750 0.0050 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 ea6abb4182a48f0934f3e9eb5affa056 DILVA 12697455440 NULL 12697455440 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1750 0.0050 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 ea6abb4182a48f0934f3e9eb5affa056 DILVA 12697455440 NULL 12697455440 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1750 0.0050 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 500e4b8f04552b423f9db8f81073659f FIDELIS 12763450340 NULL 12763450340 00817 ALGODAO HIDROFILO BOLINHA UN 0.1300 0.1200 0.0000 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 500e4b8f04552b423f9db8f81073659f FIDELIS 12763450340 NULL 12763450340 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1760 0.0040 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 27600 ONDANSETRONA 2 MG/ML 4 ML SI IM IV AP 13.5300 0.0000 13.5300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 27600 ONDANSETRONA 2 MG/ML 4 ML SI IM IV AP 13.5300 0.0000 13.5300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 11193 CLOREXIDINA 2 % ST TP ML 0.5300 0.0000 0.5300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 17310 IODOPOVIDONA ALCOOLICA SL TP ML 0.6000 0.0000 0.6000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 08435 EQUIPO P/ BOMBA DE INFUSAO ENTERAL / PARENT 20.2800 0.0000 20.2800 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 00817 ALGODAO HIDROFILO BOLINHA UN 0.5100 0.2600 0.2500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 22748 LIDOCAINA 2% GE TP OU GR 2.5900 1.3000 1.2900 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 02720 BOLSA COLETORA (SISTEMA ABERTO) UN 1.2800 0.9600 0.3200 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 31d18d6607d9e742c53e748d6a55d740 CARLOS 12557779343 NULL 12557779343 07722 DRENO DE SUCÇAO UN 26.0000 0.0000 26.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 00817 ALGODAO HIDROFILO BOLINHA UN 0.2600 0.1300 0.1300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 33219 LUVA DE PROCEDIMENTO UNIDADE UN 1.0000 0.6700 0.3300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 00817 ALGODAO HIDROFILO BOLINHA UN 0.2600 0.1300 0.1300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 37761 ALCOOL ETILICO 70 % ST TP ML 0.0300 0.0200 0.0100 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 00817 ALGODAO HIDROFILO BOLINHA UN 0.2600 0.1300 0.1300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 33219 LUVA DE PROCEDIMENTO UNIDADE UN 1.0000 0.6700 0.3300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 30376 BROMETO DE IPRATROPIO 0,25MG/ML SL IN GT 0.1000 0.0000 0.1000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 5f044434edae42d3d17c4392018c7824 DINORA 12673932742 NULL 12673932742 32204 CLORETO DE SODIO 0,9% 10 ML SI IV AP 0.4800 0.0000 0.4800 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 5f044434edae42d3d17c4392018c7824 DINORA 12673932742 NULL 12673932742 00817 ALGODAO HIDROFILO BOLINHA UN 0.1300 0.0000 0.1300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 d4089ccef13567fd45b16fb0b60685fa VERA 12656425943 NULL 12656425943 33219 LUVA DE PROCEDIMENTO UNIDADE UN 1.0000 0.0000 1.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 d4089ccef13567fd45b16fb0b60685fa VERA 12656425943 NULL 12656425943 53660 EQUIPO MACRO-GOTAS FLEXIVEL C/ INJETOR LATE 1.5900 0.0000 1.5900 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 d4089ccef13567fd45b16fb0b60685fa VERA 12656425943 NULL 12656425943 33219 LUVA DE PROCEDIMENTO UNIDADE UN 1.6700 0.6700 1.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 37761 ALCOOL ETILICO 70 % ST TP ML 0.0600 0.0300 0.0300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 27600 ONDANSETRONA 2 MG/ML 4 ML SI IM IV AP 13.5300 0.0000 13.5300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 57495 FILTRO BARREIRA E REGENERADOR DE CALOR E UM 24.0000 0.0000 24.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 27308 FIO MONOCRYL 5-0 C /AGULHA 1,65 45CM Y844G 44.2600 0.0000 44.2600 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 00817 ALGODAO HIDROFILO BOLINHA UN 0.5100 0.2600 0.2500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 00817 ALGODAO HIDROFILO BOLINHA UN 0.5100 0.2600 0.2500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 11134 HEPARINA 5000 UI/ML 5 ML SI IV SC ML 14.4000 0.0000 14.4000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cd2840524be5a3f1d0939f241e24f32b MARIA 12705908340 NULL 12705908340 33219 LUVA DE PROCEDIMENTO UNIDADE UN 1.0000 0.6700 0.3300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cd2840524be5a3f1d0939f241e24f32b MARIA 12705908340 NULL 12705908340 33219 LUVA DE PROCEDIMENTO UNIDADE UN 1.0000 0.6700 0.3300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cd2840524be5a3f1d0939f241e24f32b MARIA 12705908340 NULL 12705908340 33219 LUVA DE PROCEDIMENTO UNIDADE UN 1.0000 0.6700 0.3300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cd2840524be5a3f1d0939f241e24f32b MARIA 12705908340 NULL 12705908340 33219 LUVA DE PROCEDIMENTO UNIDADE UN 1.0000 0.6700 0.3300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cd2840524be5a3f1d0939f241e24f32b MARIA 12705908340 NULL 12705908340 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.0000 0.1800 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12603877940 NULL 12603877940 07269 DIPIRONA 500 MG/ML 2 ML SI IV IM AP 4.1200 3.4300 0.6900 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12603877940 NULL 12603877940 33227 LUVA CIRURGICA PAR UN 10.1300 5.7900 4.3400 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12603877940 NULL 12603877940 00817 ALGODAO HIDROFILO BOLINHA UN 0.2600 0.1300 0.1300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12603877940 NULL 12603877940 55018 ALGINATO DE CALCIO EM HIDROGEL GL TP GR 20.7000 13.8000 6.9000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12603877940 NULL 12603877940 28959 DERSANI LC TP ML 29.1000 19.4000 9.7000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12603877940 NULL 12603877940 37761 ALCOOL ETILICO 70 % ST TP ML 0.0300 0.0200 0.0100 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12603877940 NULL 12603877940 08664 ESPARADRAPO MICROPORE 50 X 10 CM CM 3.5800 2.5600 1.0200 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 37761 ALCOOL ETILICO 70 % ST TP ML 0.0300 0.0200 0.0100 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 4668d2494ed6c4b2d18be299efcb26a2 JOAO 12469689344 NULL 12469689344 25040014 ASSISTENCIA FISIATRICA RESPIRATORIA 0.0000 15.0800 NULL ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 818a6f2e549cc6a60aa20f9d0595eec9 ANTONIO 12565134343 NULL 12565134343 22896 CEFUROXIMA 750 MG + DIL. 6 ML PO IM IV FA 52.2500 52.2400 0.0000 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 818a6f2e549cc6a60aa20f9d0595eec9 ANTONIO 12565134343 NULL 12565134343 19160 SERINGA DESC 20 ML UN 0.5400 0.5371 0.0029 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 33219 LUVA DE PROCEDIMENTO UNIDADE UN 1.0000 0.6700 0.3300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 33219 LUVA DE PROCEDIMENTO UNIDADE UN 1.0000 0.6700 0.3300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 a050ed50115d2a6dd0b15b99b39063da ARI 12676101147 NULL 12676101147 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4064 0.0036 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 a050ed50115d2a6dd0b15b99b39063da ARI 12676101147 NULL 12676101147 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4067 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 4ff3856efb5e71b547222c677fd1e9f1 DIVINO 12652092848 NULL 12652092848 33219 LUVA DE PROCEDIMENTO UNIDADE UN 1.6700 1.6600 0.0000 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 39df67956a358bf1eab89803158d25dd HELENA 12655863342 NULL 12655863342 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1750 0.0050 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 39df67956a358bf1eab89803158d25dd HELENA 12655863342 NULL 12655863342 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1750 0.0050 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 cb57fc8e673b7c8bc339e1fe25d70cd5 HELIO 12661165148 NULL 12661165148 07269 DIPIRONA 500 MG/ML 2 ML SI IV IM AP 0.6900 0.6866 0.0034 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 9d06dbe3a8516628c3a045963dfb9c42 INAN 12623574546 NULL 12623574546 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1757 0.0043 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 4668d2494ed6c4b2d18be299efcb26a2 JOAO 12469689344 NULL 12469689344 05975 COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER 0.3000 0.0000 0.3000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 53660 EQUIPO MACRO-GOTAS FLEXIVEL C/ INJETOR LATE 4.7700 1.5900 3.1800 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 01081197 5b1e846d62341272eec7cc65f2fed2e7 ANGELIA 12734666120 NULL 12734666120 20010010 ECG - ELETROCARDIOGRAMA 0.0000 11.5710 NULL ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 01081197 2bf69eac10c578157e3a3b03e18eccde DIRCE 12676225126 NULL 12676225126 32050054 RX - RADIOGRAFIA DE TORAX - PA E PERFIL 0.0000 14.1474 NULL ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 8a5ecfde671848d05ac757e0112e689c TEREZINHA 12700337042 NULL 12700337042 25040014 ASSISTENCIA FISIATRICA RESPIRATORIA 0.0000 20.1100 NULL ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1770 0.0030 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1770 0.0030 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1770 0.0030 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1770 0.0030 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1770 0.0030 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1770 0.0030 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8072 0.0028 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 09733 ACETILCISTEINA 600MG PO VO SA 3.5000 3.4955 0.0045 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4074 0.0026 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 08664 ESPARADRAPO MICROPORE 50 X 10 CM CM 0.2600 0.2561 0.0039 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 20672 SORO RINGER SIMPLES 500 ML SI IV BS 5.9400 5.9367 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 20672 SORO RINGER SIMPLES 500 ML SI IV BS 5.9400 5.9367 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 58661 ENCRISE (ARGIPRESSINA) 20 U/ML 1 ML SI SC 20.1200 20.1171 0.0029 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 22896 CEFUROXIMA 750 MG + DIL. 6 ML PO IM IV FA 26.1300 26.1271 0.0029 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4078 0.0022 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4078 0.0022 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4078 0.0022 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4078 0.0022 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4078 0.0022 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4078 0.0022 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 33227 LUVA CIRURGICA PAR UN 1.4500 1.4476 0.0024 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 33227 LUVA CIRURGICA PAR UN 1.4500 1.4476 0.0024 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 33227 LUVA CIRURGICA PAR UN 1.4500 1.4476 0.0024 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1038 -0.0038 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 b288bbcfb9aecab51bcb0dba62ca0059 IVONETE 12743730847 NULL 12743730847 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4067 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 b288bbcfb9aecab51bcb0dba62ca0059 IVONETE 12743730847 NULL 12743730847 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4067 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 b288bbcfb9aecab51bcb0dba62ca0059 IVONETE 12743730847 NULL 12743730847 19160 SERINGA DESC 20 ML UN 0.5400 0.5359 0.0041 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 b288bbcfb9aecab51bcb0dba62ca0059 IVONETE 12743730847 NULL 12743730847 19160 SERINGA DESC 20 ML UN 0.5400 0.5367 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 b288bbcfb9aecab51bcb0dba62ca0059 IVONETE 12743730847 NULL 12743730847 19160 SERINGA DESC 20 ML UN 0.5400 0.5367 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1900 0.1900 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1800 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 00817 ALGODAO HIDROFILO BOLINHA UN 0.1000 0.0000 0.1000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4084 0.0016 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4084 0.0016 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4084 0.0016 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4084 0.0016 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4084 0.0016 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1036 -0.0036 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1036 -0.0036 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1036 -0.0036 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 62aae4e8542779ba735279cbf8749d41 LAENE 12728266347 NULL 12728266347 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4000 0.0000 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 32204 CLORETO DE SODIO 0,9% 10 ML SI IV AP 0.4800 0.0000 0.4800 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 32204 CLORETO DE SODIO 0,9% 10 ML SI IV AP 0.4800 0.4800 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 32204 CLORETO DE SODIO 0,9% 10 ML SI IV AP 0.4800 0.4800 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8067 0.0033 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8067 0.0033 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8067 0.0033 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8067 0.0033 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8067 0.0033 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8067 0.0033 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8067 0.0033 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8067 0.0033 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8067 0.0033 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8067 0.0033 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 32204 CLORETO DE SODIO 0,9% 10 ML SI IV AP 0.4800 0.4800 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.4000 0.0000 0.4000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.4040 0.4060 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 32204 CLORETO DE SODIO 0,9% 10 ML SI IV AP 0.9600 0.0000 0.9600 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 32204 CLORETO DE SODIO 0,9% 10 ML SI IV AP 0.9600 0.0000 0.9600 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 30376 BROMETO DE IPRATROPIO 0,25MG/ML SL IN GT 0.8000 0.0000 0.8000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 32204 CLORETO DE SODIO 0,9% 10 ML SI IV AP 0.4800 0.0000 0.4800 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 00485 AGUA BIDESTILADA 500 ML SI IM IV BS 6.4300 6.4200 0.0000 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 05975 COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER 0.3000 0.3833 -0.0833 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 05975 COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER 0.3000 0.3834 -0.0834 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 05975 COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER 0.3000 0.3833 -0.0833 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 19119 SERINGA DESC 01 ML (INSULINA) UN 0.3100 0.3050 0.0050 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 33537 PIPERACILINA 2 G + TAZOBACTAM 250 MG 30 ML 55.3400 55.3375 0.0025 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 33537 PIPERACILINA 2 G + TAZOBACTAM 250 MG 30 ML 55.3400 55.3375 0.0025 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 33537 PIPERACILINA 2 G + TAZOBACTAM 250 MG 30 ML 55.3400 55.3375 0.0025 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 33537 PIPERACILINA 2 G + TAZOBACTAM 250 MG 30 ML 55.3400 55.3375 0.0025 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 33537 PIPERACILINA 2 G + TAZOBACTAM 250 MG 30 ML 55.3400 55.3375 0.0025 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 42358 FUROSEMIDA 10 MG/ML 2 ML SI IM IV AP 1.2000 1.1964 0.0036 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4061 0.0039 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4061 0.0039 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4061 0.0039 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4061 0.0039 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 33227 LUVA CIRURGICA PAR UN 1.4500 1.4477 0.0023 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 33227 LUVA CIRURGICA PAR UN 1.4500 1.4477 0.0023 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 33227 LUVA CIRURGICA PAR UN 1.4500 1.4477 0.0023 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 33227 LUVA CIRURGICA PAR UN 1.4500 1.4477 0.0023 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 33227 LUVA CIRURGICA PAR UN 1.4500 1.4477 0.0023 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 33227 LUVA CIRURGICA PAR UN 1.4500 1.4477 0.0023 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 19135 SERINGA DESC 03 ML UN 0.1500 0.0000 0.1500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 19135 SERINGA DESC 03 ML UN 0.3000 0.3000 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 19151 SERINGA DESC 10 ML UN 0.6700 0.6657 0.0043 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.2100 0.2057 0.0043 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.2100 0.2057 0.0043 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1772 0.0028 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1772 0.0028 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cd2840524be5a3f1d0939f241e24f32b MARIA 12705908340 NULL 12705908340 32204 CLORETO DE SODIO 0,9% 10 ML SI IV AP 0.4800 0.0000 0.4800 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cd2840524be5a3f1d0939f241e24f32b MARIA 12705908340 NULL 12705908340 32204 CLORETO DE SODIO 0,9% 10 ML SI IV AP 0.4800 0.0000 0.4800 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cd2840524be5a3f1d0939f241e24f32b MARIA 12705908340 NULL 12705908340 32204 CLORETO DE SODIO 0,9% 10 ML SI IV AP 0.4800 0.4800 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cd2840524be5a3f1d0939f241e24f32b MARIA 12705908340 NULL 12705908340 32204 CLORETO DE SODIO 0,9% 10 ML SI IV AP 0.4800 0.4800 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cd2840524be5a3f1d0939f241e24f32b MARIA 12705908340 NULL 12705908340 32204 CLORETO DE SODIO 0,9% 10 ML SI IV AP 0.4800 0.4800 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cd2840524be5a3f1d0939f241e24f32b MARIA 12705908340 NULL 12705908340 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1764 0.0036 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cd2840524be5a3f1d0939f241e24f32b MARIA 12705908340 NULL 12705908340 02461 FENOTEROL 2 MG/ML 10 ML AE IN DS 0.4300 0.0000 0.4300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 d17b3c5ae418d82694895a326dee545a ODILIA 12670516743 NULL 12670516743 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1774 0.0026 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1766 0.0034 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1766 0.0034 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1766 0.0034 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1766 0.0034 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 1.6200 1.6154 0.0046 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 8a5ecfde671848d05ac757e0112e689c TEREZINHA 12700337042 NULL 12700337042 19518 SOLUÇAO DE GLICERINA 12% 500 ML SL VR FR 8.8600 8.8500 0.0000 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 8a5ecfde671848d05ac757e0112e689c TEREZINHA 12700337042 NULL 12700337042 10626 GLICOSE 50% 10 ML SI IV AP 2.7400 2.7350 0.0050 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 8a5ecfde671848d05ac757e0112e689c TEREZINHA 12700337042 NULL 12700337042 09733 ACETILCISTEINA 600MG PO VO SA 3.5000 3.4965 0.0035 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 8a5ecfde671848d05ac757e0112e689c TEREZINHA 12700337042 NULL 12700337042 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4071 0.0029 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 8a5ecfde671848d05ac757e0112e689c TEREZINHA 12700337042 NULL 12700337042 19160 SERINGA DESC 20 ML UN 0.5400 0.5376 0.0024 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 8a5ecfde671848d05ac757e0112e689c TEREZINHA 12700337042 NULL 12700337042 19160 SERINGA DESC 20 ML UN 0.5400 0.5376 0.0024 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 8a5ecfde671848d05ac757e0112e689c TEREZINHA 12700337042 NULL 12700337042 19160 SERINGA DESC 20 ML UN 0.5400 0.5376 0.0024 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 8a5ecfde671848d05ac757e0112e689c TEREZINHA 12700337042 NULL 12700337042 19160 SERINGA DESC 20 ML UN 0.5400 0.5376 0.0024 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 8a5ecfde671848d05ac757e0112e689c TEREZINHA 12700337042 NULL 12700337042 19160 SERINGA DESC 20 ML UN 0.5400 0.5376 0.0024 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 70cf23c63f890f0b61da2542c3e13a09 TIAGO 12741864645 NULL 12741864645 07269 DIPIRONA 500 MG/ML 2 ML SI IV IM AP 1.3700 1.3600 0.0000 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 70cf23c63f890f0b61da2542c3e13a09 TIAGO 12741864645 NULL 12741864645 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1766 0.0034 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 70cf23c63f890f0b61da2542c3e13a09 TIAGO 12741864645 NULL 12741864645 19160 SERINGA DESC 20 ML UN 0.5400 0.5367 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 70cf23c63f890f0b61da2542c3e13a09 TIAGO 12741864645 NULL 12741864645 19160 SERINGA DESC 20 ML UN 0.5400 0.5367 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 0111beed375944f60c7ad4a7fd4874f8 WALDIR 12746025744 NULL 12746025744 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8074 0.0026 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 0111beed375944f60c7ad4a7fd4874f8 WALDIR 12746025744 NULL 12746025744 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 1.6200 1.6147 0.0053 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 0111beed375944f60c7ad4a7fd4874f8 WALDIR 12746025744 NULL 12746025744 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4068 0.0032 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 0111beed375944f60c7ad4a7fd4874f8 WALDIR 12746025744 NULL 12746025744 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4076 0.0024 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 0111beed375944f60c7ad4a7fd4874f8 WALDIR 12746025744 NULL 12746025744 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4076 0.0024 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 0111beed375944f60c7ad4a7fd4874f8 WALDIR 12746025744 NULL 12746025744 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4076 0.0024 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 0111beed375944f60c7ad4a7fd4874f8 WALDIR 12746025744 NULL 12746025744 19160 SERINGA DESC 20 ML UN 0.5400 0.5379 0.0021 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 52353 ABAIXADOR DE LINGUA UN 0.0500 0.0267 0.0233 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 00817 ALGODAO HIDROFILO BOLINHA UN 0.1300 0.0000 0.1300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 00817 ALGODAO HIDROFILO BOLINHA UN 0.5100 0.2600 0.2500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 00035 ABOCATH (CATETER INTRAVENOSO) N. 14 A 22 UN 7.5300 7.5300 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 37761 ALCOOL ETILICO 70 % ST TP ML 0.0600 0.0300 0.0300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 27596 TIRA TESTE PARA GLICOSE UN 1.0400 1.0400 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 05975 COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER 0.3000 0.0000 0.3000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 05975 COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER 0.3000 0.3000 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 05975 COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER 0.3000 0.3000 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 05975 COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER 0.3000 0.0000 0.3000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 05975 COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER 0.3000 0.0000 0.3000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12647284040 NULL 12647284040 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4086 0.0014 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12662414945 NULL 12662414945 33219 LUVA DE PROCEDIMENTO UNIDADE UN 0.6700 0.6657 0.0043 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12662414945 NULL 12662414945 33219 LUVA DE PROCEDIMENTO UNIDADE UN 1.6700 1.6643 0.0057 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12662414945 NULL 12662414945 33219 LUVA DE PROCEDIMENTO UNIDADE UN 1.6700 1.6643 0.0057 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12662414945 NULL 12662414945 19160 SERINGA DESC 20 ML UN 0.5400 0.5367 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12662414945 NULL 12662414945 13404 OMEPRAZOL 40 MG + DIL. 10 ML PO IV FA 19.5800 19.5750 0.0050 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12662414945 NULL 12662414945 19445 CLORETO DE POTASSIO 600 MG CA VO UN 0.4900 0.4867 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12662414945 NULL 12662414945 19445 CLORETO DE POTASSIO 600 MG CA VO UN 0.4900 0.4867 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12662414945 NULL 12662414945 19445 CLORETO DE POTASSIO 600 MG CA VO UN 0.4900 0.4867 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12662414945 NULL 12662414945 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4071 0.0029 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12662414945 NULL 12662414945 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4071 0.0029 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 05975 COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER 0.3000 0.1500 0.1500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 33227 LUVA CIRURGICA PAR UN 1.4500 1.4476 0.0024 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 33227 LUVA CIRURGICA PAR UN 1.4500 1.4476 0.0024 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 33227 LUVA CIRURGICA PAR UN 1.4500 1.4476 0.0024 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1770 0.0030 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1770 0.0030 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1770 0.0030 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1770 0.0030 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 11700 EQUIPO P/ BOMBA DE INFUSAO ENTERAL / PARENTERAL NULL 0.0000 NULL OPME INVALIDO 2201
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 11700 EQUIPO P/ BOMBA DE INFUSAO ENTERAL / PARENTERAL NULL 0.0000 NULL OPME INVALIDO 2201
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 34789 SONDA ASPIRAÇAO C/ VALVULA - TODAS - UTI UN 0.9400 0.9367 0.0033 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 25739 ELETRODO DESCARTAVEL (UTI) UN 18.4500 4.6100 13.8400 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.0000 0.8100 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 37761 ALCOOL ETILICO 70 % ST TP ML 0.0600 0.0200 0.0400 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 33219 LUVA DE PROCEDIMENTO UNIDADE UN 0.6700 0.0000 0.6700 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00817 ALGODAO HIDROFILO BOLINHA UN 0.2600 0.1300 0.1300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 19151 SERINGA DESC 10 ML UN 0.3300 0.0000 0.3300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.2120 -0.1120 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.2120 -0.1120 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.2120 -0.1120 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.2120 -0.1120 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.2120 -0.1120 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.2120 -0.1120 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1060 -0.0060 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1060 -0.0060 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1060 -0.0060 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1060 -0.0060 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1060 -0.0060 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1060 -0.0060 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1060 -0.0060 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1060 -0.0060 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1060 -0.0060 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1060 -0.0060 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 34827 TIORFAN (RACECADOTRILA) 100 MG CA VO UN 3.2000 6.4000 -3.2000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 34827 TIORFAN (RACECADOTRILA) 100 MG CA VO UN 3.2000 6.4000 -3.2000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 34827 TIORFAN (RACECADOTRILA) 100 MG CA VO UN 3.2000 6.4000 -3.2000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 34827 TIORFAN (RACECADOTRILA) 100 MG CA VO UN 3.2000 6.4000 -3.2000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 34827 TIORFAN (RACECADOTRILA) 100 MG CA VO UN 3.2000 3.2000 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 27596 TIRA TESTE PARA GLICOSE UN 1.0400 2.0800 -1.0400 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 27596 TIRA TESTE PARA GLICOSE UN 1.0400 1.0400 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 27596 TIRA TESTE PARA GLICOSE UN 1.0400 1.0400 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 19160 SERINGA DESC 20 ML UN 0.5400 0.5374 0.0026 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 19160 SERINGA DESC 20 ML UN 0.5400 0.5374 0.0026 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 07587 DRAMIN B6 DL (DIMENIDRINATO + PIRIDOXINA + 13.2771 15.4939 -13.2839 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 07587 DRAMIN B6 DL (DIMENIDRINATO + PIRIDOXINA + 11.0637 13.2805 -11.0705 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 31585 RANITIDINA 25 MG/ML 2 ML SI IV IM AP 0.9300 1.8668 -0.9368 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 31585 RANITIDINA 25 MG/ML 2 ML SI IV IM AP 0.9300 0.9334 -0.0034 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 31585 RANITIDINA 25 MG/ML 2 ML SI IV IM AP 0.9300 0.9334 -0.0034 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 19151 SERINGA DESC 10 ML UN 0.6634 1.0003 -0.6703 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 19151 SERINGA DESC 10 ML UN 0.3300 0.6669 -0.3369 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 19151 SERINGA DESC 10 ML UN 0.3300 0.6669 -0.3369 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 19151 SERINGA DESC 10 ML UN 0.3300 0.6669 -0.3369 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 13935 METAMUCIL (PLANTAGO OVATA) 5,85 G PO VO E 2.4600 4.9271 -2.4671 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 37761 ALCOOL ETILICO 70 % ST TP ML 0.0598 0.0662 -0.0362 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 53660 EQUIPO MACRO-GOTAS FLEXIVEL C/ INJETOR LATE 1.5900 1.5900 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 53660 EQUIPO MACRO-GOTAS FLEXIVEL C/ INJETOR LATE 1.5900 1.5900 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 11193 CLOREXIDINA 2 % ST TP ML 0.5300 0.5320 -0.0020 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 05975 COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER 0.7739 0.8059 -0.7759 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 05975 COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER 0.7739 0.8059 -0.7759 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 800720d33fe0defb6121e82dd216d044 JALMO 12786952647 NULL 12786952647 102001 DIARIA DE APARTAMENTO 0.0000 288.8900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 800720d33fe0defb6121e82dd216d044 JALMO 12786952647 NULL 12786952647 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 0.0000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4075 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4075 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00020010 Visita Hospitalar (Paciente Internado) 0.0000 438.0000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 02246 HIDROCORTISONA 100 MG PO IM IV FA 0.0000 2.8300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 02246 HIDROCORTISONA 100 MG PO IM IV FA 0.0000 5.6700 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 02246 HIDROCORTISONA 100 MG PO IM IV FA 0.0000 5.6700 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 26981 SORO FISIOLOGICO 0,9% 10 ML SI IV AP 0.0000 0.0000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 26981 SORO FISIOLOGICO 0,9% 10 ML SI IV AP 0.0000 0.0000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 26981 SORO FISIOLOGICO 0,9% 10 ML SI IV AP 0.0000 0.0000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 26981 SORO FISIOLOGICO 0,9% 10 ML SI IV AP 0.0000 0.0000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00613 CLINDAMICINA 600 MG 4 ML SI IM IV AP 0.0000 13.0800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00613 CLINDAMICINA 600 MG 4 ML SI IM IV AP 0.0000 13.0800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00613 CLINDAMICINA 600 MG 4 ML SI IM IV AP 0.0000 13.0800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 07802 PIPERACILINA 4 G + TAZOBACTAM 500 MG PO IV FA 0.0000 83.4500 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 08829 Bricanyl 0,5mg Inj. Ampola C/ 1ml 0.0000 3.5900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00090 SERINGA DESC 20 ML UN 0.0000 0.0000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00091 SERINGA DESC 01 ML (INSULINA) UN 0.0000 0.3057 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00091 SERINGA DESC 01 ML (INSULINA) UN 0.0000 0.3057 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00124 LUVA CIRURGICA UN 0.0000 1.4475 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00124 LUVA CIRURGICA UN 0.0000 1.4475 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00124 LUVA CIRURGICA UN 0.0000 1.4475 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00125 LUVA CIRURGICA UN 0.0000 1.4475 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4062 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4062 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4062 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4062 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4062 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4062 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4062 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 01584 NEOSTIGMINA 0,5 MG/ML 1 ML SI IM IV SC AP 0.0000 0.7667 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 01584 NEOSTIGMINA 0,5 MG/ML 1 ML SI IM IV SC AP 0.0000 0.7667 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 01584 NEOSTIGMINA 0,5 MG/ML 1 ML SI IM IV SC AP 0.0000 0.7667 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 01584 NEOSTIGMINA 0,5 MG/ML 1 ML SI IM IV SC AP 0.0000 0.7667 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 01584 NEOSTIGMINA 0,5 MG/ML 1 ML SI IM IV SC AP 0.0000 0.7667 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 01584 NEOSTIGMINA 0,5 MG/ML 1 ML SI IM IV SC AP 0.0000 0.7667 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00170 SORO GLICOSADO 5% 250 ML SI IV BS 0.0000 3.4000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00170 SORO GLICOSADO 5% 250 ML SI IV BS 0.0000 3.4000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 24082 BROMOPRIDA 5 MG/ML 2 ML SI IM IV AP 0.0000 2.7300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4088 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4088 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4088 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1766 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1766 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1766 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1766 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1766 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00090 SERINGA DESC 20 ML UN 0.0000 0.5400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00090 SERINGA DESC 20 ML UN 0.0000 0.5387 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00090 SERINGA DESC 20 ML UN 0.0000 0.5387 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00090 SERINGA DESC 20 ML UN 0.0000 0.5387 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00090 SERINGA DESC 20 ML UN 0.0000 0.5387 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00090 SERINGA DESC 20 ML UN 0.0000 0.5387 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00090 SERINGA DESC 20 ML UN 0.0000 0.5387 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00090 SERINGA DESC 20 ML UN 0.0000 0.5387 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00090 SERINGA DESC 20 ML UN 0.0000 0.5387 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00090 SERINGA DESC 20 ML UN 0.0000 0.5387 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00090 SERINGA DESC 20 ML UN 0.0000 0.5387 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00090 SERINGA DESC 20 ML UN 0.0000 0.5387 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00090 SERINGA DESC 20 ML UN 0.0000 0.5387 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4070 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 00124 LUVA CIRURGICA UN 0.0000 1.4473 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 00125 LUVA CIRURGICA UN 0.0000 1.4473 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4074 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4074 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4074 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 01611 CLORETO DE POTASSIO 600 MG CA VO UN 0.0000 0.4867 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 25040014 Fisioterapia Respiratória - em Doente Clínico Internado 0.0000 5.0300 NULL EXAME NAO AUTORIZADO 2707
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 25040014 Fisioterapia Respiratória - em Doente Clínico Internado 0.0000 10.0600 NULL EXAME NAO AUTORIZADO 2707
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 25040014 Fisioterapia Respiratória - em Doente Clínico Internado 0.0000 10.0600 NULL EXAME NAO AUTORIZADO 2707
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.8089 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1775 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1775 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1775 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1775 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1800 NULL VALOR APRESENTADO A MAIOR 1705
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1775 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1775 NULL VALOR APRESENTADO A MAIOR 1705
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1775 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 00090 SERINGA DESC 20 ML UN 0.0000 0.5400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 35382 COMPRESSAS DE GASES 7.5 X7,5 (11 FIOS ESTERIL) UN 0.0000 0.0000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 51584 ESPARADRAPO MICROPORE 0.0000 0.2600 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 51584 ESPARADRAPO MICROPORE 0.0000 0.2600 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 51584 ESPARADRAPO MICROPORE 0.0000 0.2600 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 51584 ESPARADRAPO MICROPORE 0.0000 0.2600 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 51584 ESPARADRAPO MICROPORE 0.0000 0.2600 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 51588 ESPARADRAPO MICROPORE 50 X 10 CM CM 0.0000 0.2600 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 00090 SERINGA DESC 20 ML UN 0.0000 0.5367 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 00124 LUVA CIRURGICA UN 0.0000 1.4482 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 00124 LUVA CIRURGICA UN 0.0000 1.4482 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 00124 LUVA CIRURGICA UN 0.0000 1.4482 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 00124 LUVA CIRURGICA UN 0.0000 1.4482 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 00124 LUVA CIRURGICA UN 0.0000 1.4500 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 00124 LUVA CIRURGICA UN 0.0000 1.4500 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 00124 LUVA CIRURGICA UN 0.0000 1.4500 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 00124 LUVA CIRURGICA UN 0.0000 1.4500 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 00128 LUVA DE PROCEDIMENTO UNIDADE UN 0.0000 1.6700 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4094 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.4000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1752 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1752 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1752 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1752 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 51241 AGULHA 123X45 0.0000 0.1900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 51590 ABAIXADOR DE LINGUA UN 0.0000 0.0500 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 51649 ALCOOL ETILICO 70 % ST TP ML 0.0000 0.0300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 52392 SONDA DE ASPIRAÇAO TRAQUEAL C/ VALVULA UN 0.0000 0.9400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 52392 SONDA DE ASPIRAÇAO TRAQUEAL C/ VALVULA UN 0.0000 0.9352 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 52392 SONDA DE ASPIRAÇAO TRAQUEAL C/ VALVULA UN 0.0000 0.9352 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 52392 SONDA DE ASPIRAÇAO TRAQUEAL C/ VALVULA UN 0.0000 0.9400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 52392 SONDA DE ASPIRAÇAO TRAQUEAL C/ VALVULA UN 0.0000 0.9352 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 35382 COMPRESSAS DE GASES 7.5 X7,5 (11 FIOS ESTERIL) UN 0.0000 0.6000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 35382 COMPRESSAS DE GASES 7.5 X7,5 (11 FIOS ESTERIL) UN 0.0000 0.6000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 35382 COMPRESSAS DE GASES 7.5 X7,5 (11 FIOS ESTERIL) UN 0.0000 0.6000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.3500 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.3500 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 51241 AGULHA 123X45 0.0000 0.5800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00128 LUVA DE PROCEDIMENTO UNIDADE UN 0.0000 1.6700 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00128 LUVA DE PROCEDIMENTO UNIDADE UN 0.0000 1.6700 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 01496 FENITOINA 50 MG/ML 5 ML SI IM IV AP 0.0000 2.3400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 01584 NEOSTIGMINA 0,5 MG/ML 1 ML SI IM IV SC AP 0.0000 0.7662 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 01584 NEOSTIGMINA 0,5 MG/ML 1 ML SI IM IV SC AP 0.0000 0.7662 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 01584 NEOSTIGMINA 0,5 MG/ML 1 ML SI IM IV SC AP 0.0000 0.7662 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 24082 BROMOPRIDA 5 MG/ML 2 ML SI IM IV AP 0.0000 2.7300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 26981 SORO FISIOLOGICO 0,9% 10 ML SI IV AP 0.0000 0.9600 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 26981 SORO FISIOLOGICO 0,9% 10 ML SI IV AP 0.0000 0.9600 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 26981 SORO FISIOLOGICO 0,9% 10 ML SI IV AP 0.0000 0.9600 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ea4ad2636c25d8e3dbb569ae62db71e7 IONE 12489788840 NULL 12489788840 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.4000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ea4ad2636c25d8e3dbb569ae62db71e7 IONE 12489788840 NULL 12489788840 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.4000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 d17b3c5ae418d82694895a326dee545a ODILIA 12670516743 NULL 12670516743 51230 AGULHA DESC 30 X 7 - 40X12 UN NULL 0.0000 NULL OPME INVALIDO 2201
Glosa Min 2018-10-03 00:00:00.000000 1084117 d17b3c5ae418d82694895a326dee545a ODILIA 12670516743 NULL 12670516743 102001 DIARIA DE APARTAMENTO 0.0000 288.8882 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 d17b3c5ae418d82694895a326dee545a ODILIA 12670516743 NULL 12670516743 01137 SONDA URETRAL N 12 UN 0.0000 0.7500 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 d17b3c5ae418d82694895a326dee545a ODILIA 12670516743 NULL 12670516743 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 d17b3c5ae418d82694895a326dee545a ODILIA 12670516743 NULL 12670516743 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 d17b3c5ae418d82694895a326dee545a ODILIA 12670516743 NULL 12670516743 02197 METAMUCIL (PLANTAGO OVATA) 3,4 G PO VO EV 0.0000 2.4600 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 d17b3c5ae418d82694895a326dee545a ODILIA 12670516743 NULL 12670516743 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 d17b3c5ae418d82694895a326dee545a ODILIA 12670516743 NULL 12670516743 00431 ETOMIDATO 2 MG/ML 10 ML SI IV AP 0.0000 7.0000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 d17b3c5ae418d82694895a326dee545a ODILIA 12670516743 NULL 12670516743 51208 SORO RINGER SIMPLES 500 ML SI IV BS 0.0000 5.9400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 d17b3c5ae418d82694895a326dee545a ODILIA 12670516743 NULL 12670516743 51208 SORO RINGER SIMPLES 500 ML SI IV BS 0.0000 5.9400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 102001 DIARIA DE APARTAMENTO 0.0000 288.8882 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 102001 DIARIA DE APARTAMENTO 0.0000 288.8882 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4074 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4074 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4072 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 01611 CLORETO DE POTASSIO 600 MG CA VO UN 0.0000 0.4867 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 02246 HIDROCORTISONA 100 MG PO IM IV FA 0.0000 2.8300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 02246 HIDROCORTISONA 100 MG PO IM IV FA 0.0000 2.8300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 02246 HIDROCORTISONA 100 MG PO IM IV FA 0.0000 2.8300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 25030019 Distúrbios Circulatórios Artério - Venosos e Linfáticos 0.0000 57.3200 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 26981 SORO FISIOLOGICO 0,9% 10 ML SI IV AP 0.0000 0.4800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 26981 SORO FISIOLOGICO 0,9% 10 ML SI IV AP 0.0000 0.4800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 26981 SORO FISIOLOGICO 0,9% 10 ML SI IV AP 0.0000 0.4800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 00404 LACTULOSE 667 MG/ML XP VO ML 0.0000 0.0000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 00404 LACTULOSE 667 MG/ML XP VO ML 0.0000 6.4300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 00404 LACTULOSE 667 MG/ML XP VO ML 0.0000 6.4300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 00404 LACTULOSE 667 MG/ML XP VO ML 0.0000 6.4300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 51163 AGUA BIDESTILADA 250 ML 0.0000 5.4539 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1771 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1771 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1771 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1771 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1771 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1771 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1771 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1771 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1771 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1771 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1771 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 081fdadb830fb547e83c43fabdb88372 ELZA 12377335349 NULL 12377335349 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 081fdadb830fb547e83c43fabdb88372 ELZA 12377335349 NULL 12377335349 09071 ACETILCISTEINA 600MG PO VO SA 0.0000 3.5000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 00172 SORO FISIOLOGICO 0,9% 500 ML SI IV BS 0.0000 9.4698 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 24571 CLINDAMICINA 600 MG 4 ML SI IM IV AP 0.0000 13.0800 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 24571 CLINDAMICINA 600 MG 4 ML SI IM IV AP 0.0000 13.0800 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 24571 CLINDAMICINA 600 MG 4 ML SI IM IV AP 0.0000 13.0800 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 24571 CLINDAMICINA 600 MG 4 ML SI IM IV AP 0.0000 13.0800 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR APRESENTADO A MAIOR 1705
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR APRESENTADO A MAIOR 1705
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR APRESENTADO A MAIOR 1705
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 25040014 Fisioterapia Respiratória - em Doente Clínico Internado 0.0000 15.4600 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 26981 SORO FISIOLOGICO 0,9% 10 ML SI IV AP 0.0000 0.9600 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 03280 CLOREXIDINA 2 % ST TP ML 0.0000 0.5300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 03280 CLOREXIDINA 2 % ST TP ML 0.0000 0.8000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 00406 FUROSEMIDA 10 MG/ML 2 ML SI IM IV AP 0.0000 0.6000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 00406 FUROSEMIDA 10 MG/ML 2 ML SI IM IV AP 0.0000 0.6000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 00406 FUROSEMIDA 10 MG/ML 2 ML SI IM IV AP 0.0000 0.6000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 00487 RANITIDINA 25 MG/ML 2 ML SI IM IV AP 0.0000 0.9300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 00487 RANITIDINA 25 MG/ML 2 ML SI IM IV AP 0.0000 0.9300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.8100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.8100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 51379 SERINGA DESC 05 ML UN 0.0000 0.1900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 51379 SERINGA DESC 05 ML UN 0.0000 0.1900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 51379 SERINGA DESC 05 ML UN 0.0000 0.1900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 51379 SERINGA DESC 05 ML UN 0.0000 0.1900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 51379 SERINGA DESC 05 ML UN 0.0000 0.1900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 51379 SERINGA DESC 05 ML UN 0.0000 0.1900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 51589 ESPARADRAPO 10 X 4.5 CM CM 0.0000 0.4000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 51589 ESPARADRAPO 10 X 4.5 CM CM 0.0000 0.4000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 51589 ESPARADRAPO 10 X 4.5 CM CM 0.0000 0.4000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 52941 Clorexidina Degermante 2% Fr30ml - Solução De Uso Tópico 0.0000 0.8000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 06400 CARVEDILOL 3,125 MG CP VO UN 0.0000 0.7300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 06400 CARVEDILOL 3,125 MG CP VO UN 0.0000 0.7300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 06400 CARVEDILOL 3,125 MG CP VO UN 0.0000 0.7300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 102001 DIARIA DE APARTAMENTO 0.0000 288.8900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 102001 DIARIA DE APARTAMENTO 0.0000 288.8900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 01062 CATETER OXIGENIO TIPO OCULOS UN 0.0000 0.6757 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 00128 LUVA DE PROCEDIMENTO UNIDADE UN 0.0000 1.0000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 51589 ESPARADRAPO 10 X 4.5 CM CM 0.0000 0.4000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 51649 ALCOOL ETILICO 70 % ST TP ML 0.0000 0.0300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 00090 SERINGA DESC 20 ML UN 0.0000 0.5400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 00090 SERINGA DESC 20 ML UN 0.0000 0.5400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 00090 SERINGA DESC 20 ML UN 0.0000 0.5400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 00090 SERINGA DESC 20 ML UN 0.0000 0.5400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 00090 SERINGA DESC 20 ML UN 0.0000 0.5400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 00090 SERINGA DESC 20 ML UN 0.0000 0.5400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 00090 SERINGA DESC 20 ML UN 0.0000 0.5400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 00919 ALGODAO HIDROFILO BOLINHA UN 0.0000 0.2600 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 f3ad474c8c562757c4d1a959ff0961c4 DJALMA 12718763240 NULL 12718763240 11700 EQUIPO P/ BOMBA DE INFUSAO ENTERAL / PARENTERAL 0.0000 0.0000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 f3ad474c8c562757c4d1a959ff0961c4 DJALMA 12718763240 NULL 12718763240 00037 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 f3ad474c8c562757c4d1a959ff0961c4 DJALMA 12718763240 NULL 12718763240 51584 ESPARADRAPO MICROPORE 0.0000 0.7700 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 f3ad474c8c562757c4d1a959ff0961c4 DJALMA 12718763240 NULL 12718763240 51584 ESPARADRAPO MICROPORE 0.0000 0.7700 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 f3ad474c8c562757c4d1a959ff0961c4 DJALMA 12718763240 NULL 12718763240 00090 SERINGA DESC 20 ML UN 0.0000 0.5400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 f3ad474c8c562757c4d1a959ff0961c4 DJALMA 12718763240 NULL 12718763240 00090 SERINGA DESC 20 ML UN 0.0000 0.5400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 806bfa8e76209648a4ae145ff436d092 GILBERTO 12692620640 NULL 12692620640 16961 CLOPIDOGREL 75 MG CP VO UN 0.0000 1.7900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 806bfa8e76209648a4ae145ff436d092 GILBERTO 12692620640 NULL 12692620640 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6875 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 806bfa8e76209648a4ae145ff436d092 GILBERTO 12692620640 NULL 12692620640 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3fb5c891f31bb9efcb05395066127c52 ALAIDE 12636273441 NULL 12636273441 14250 PARACETAMOL 750 MG CP VO UN 0.0000 0.0000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00090 SERINGA DESC 20 ML UN 0.5400 0.2200 0.3200 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.6900 0.2700 0.4200 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.6900 0.2700 0.4200 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00128 LUVA DE PROCEDIMENTO UNIDADE UN 1.0000 0.3900 0.6100 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00493 BROMOPRIDA 5 MG/ML 2 ML SI IM IV AP 2.7300 1.0600 1.6700 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00493 BROMOPRIDA 5 MG/ML 2 ML SI IM IV AP 2.7300 1.0600 1.6700 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00493 BROMOPRIDA 5 MG/ML 2 ML SI IM IV AP 2.7300 1.0600 1.6700 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00493 BROMOPRIDA 5 MG/ML 2 ML SI IM IV AP 2.7300 1.0600 1.6700 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 01603 GLICOSE 50% 10 ML SI IV AP 2.7400 1.0700 1.6700 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00407 HEPARINA 5000 UI/ML 5 ML SI IV SC ML 2.8800 1.1200 1.7600 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00124 LUVA CIRURGICA UN 2.9000 1.1300 1.7700 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00172 SORO FISIOLOGICO 0,9% 500 ML SI IV BS 4.7300 1.8400 2.8900 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 51163 AGUA BIDESTILADA 250 ML 5.7900 2.2600 3.5300 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 51620 Modulo Em Pó De Fibras Solúveis 7.3100 2.8500 4.4600 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00613 CLINDAMICINA 600 MG 4 ML SI IM IV AP 13.0800 5.1000 7.9800 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00613 CLINDAMICINA 600 MG 4 ML SI IM IV AP 13.0800 5.1000 7.9800 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00613 CLINDAMICINA 600 MG 4 ML SI IM IV AP 13.0800 5.1000 7.9800 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 51673 ALGINATO DE CALCIO EM HIDROGEL GL TP GR 17.2500 6.7300 10.5200 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 16b1e9f62f247f02ad5cac910ee15b4e BERCHOLINA 12631612848 NULL 12631612848 33537 PIPERACILINA 2 G + TAZOBACTAM 250 MG 30 ML 55.3400 55.3385 0.0015 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 16b1e9f62f247f02ad5cac910ee15b4e BERCHOLINA 12631612848 NULL 12631612848 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4081 0.0019 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 16b1e9f62f247f02ad5cac910ee15b4e BERCHOLINA 12631612848 NULL 12631612848 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4081 0.0019 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 16b1e9f62f247f02ad5cac910ee15b4e BERCHOLINA 12631612848 NULL 12631612848 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1900 0.1781 0.0119 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 16b1e9f62f247f02ad5cac910ee15b4e BERCHOLINA 12631612848 NULL 12631612848 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1900 0.1781 0.0119 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 16b1e9f62f247f02ad5cac910ee15b4e BERCHOLINA 12631612848 NULL 12631612848 33219 LUVA DE PROCEDIMENTO UNIDADE UN 0.8370 1.0018 -0.3318 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 16b1e9f62f247f02ad5cac910ee15b4e BERCHOLINA 12631612848 NULL 12631612848 33219 LUVA DE PROCEDIMENTO UNIDADE UN 0.8370 1.0018 -0.3318 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 16b1e9f62f247f02ad5cac910ee15b4e BERCHOLINA 12631612848 NULL 12631612848 36432 HIDROCLOROTIAZIDA 25 MG CP VO UN 0.2400 0.2300 0.0100 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 16b1e9f62f247f02ad5cac910ee15b4e BERCHOLINA 12631612848 NULL 12631612848 36432 HIDROCLOROTIAZIDA 25 MG CP VO UN 0.2400 0.2300 0.0100 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 16b1e9f62f247f02ad5cac910ee15b4e BERCHOLINA 12631612848 NULL 12631612848 00090 SERINGA DESC 20 ML UN 0.5400 0.5200 0.0200 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 16b1e9f62f247f02ad5cac910ee15b4e BERCHOLINA 12631612848 NULL 12631612848 00090 SERINGA DESC 20 ML UN 0.5400 0.5200 0.0200 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 16b1e9f62f247f02ad5cac910ee15b4e BERCHOLINA 12631612848 NULL 12631612848 00090 SERINGA DESC 20 ML UN 0.5400 0.5200 0.0200 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 16b1e9f62f247f02ad5cac910ee15b4e BERCHOLINA 12631612848 NULL 12631612848 00171 SORO FISIOLOGICO 0,9% 250 ML SI IV BS 3.9400 3.7600 0.1800 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 37761 ALCOOL ETILICO 70 % ST TP ML 0.0300 0.0200 0.0100 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 33219 LUVA DE PROCEDIMENTO UNIDADE UN 1.6700 0.6700 1.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 00817 ALGODAO HIDROFILO BOLINHA UN 0.5100 0.1300 0.3800 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 08648 ESPARADRAPO 10 X 4.5 CM CM 0.4000 0.2000 0.2000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 08648 ESPARADRAPO 10 X 4.5 CM CM 0.4000 0.2000 0.2000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 37761 ALCOOL ETILICO 70 % ST TP ML 0.0600 0.0200 0.0400 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 00817 ALGODAO HIDROFILO BOLINHA UN 0.5100 0.2600 0.2500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 32891 EQUIPO POLIFIX 2ş VIAS UN 2.5500 0.0000 2.5500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 00817 ALGODAO HIDROFILO BOLINHA UN 0.5100 0.2600 0.2500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 28959 DERSANI LC TP ML 19.4000 4.8500 14.5500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 75bcd473a0dc7c7a6751499b38a4a034 JOAQUIM 12692852143 NULL 12692852143 08648 ESPARADRAPO 10 X 4.5 CM CM 0.4000 0.1000 0.3000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 75bcd473a0dc7c7a6751499b38a4a034 JOAQUIM 12692852143 NULL 12692852143 08664 ESPARADRAPO MICROPORE 50 X 10 CM CM 0.7700 0.0000 0.7700 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 75bcd473a0dc7c7a6751499b38a4a034 JOAQUIM 12692852143 NULL 12692852143 08648 ESPARADRAPO 10 X 4.5 CM CM 0.4000 0.1000 0.3000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.0000 0.8100 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 14370 FIO MONONYLON 3-0 C/ AGULHA 2,4 3/8 163T E 13.3700 0.0000 13.3700 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 05975 COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER 0.0900 0.0000 0.0900 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12603877940 NULL 12603877940 19151 SERINGA DESC 10 ML UN 0.3300 0.0000 0.3300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 08648 ESPARADRAPO 10 X 4.5 CM CM 0.4000 0.2600 0.1400 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 05975 COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER 0.3000 0.0000 0.3000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 33219 LUVA DE PROCEDIMENTO UNIDADE UN 1.0000 0.6700 0.3300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 37761 ALCOOL ETILICO 70 % ST TP ML 0.0300 0.0200 0.0100 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 37761 ALCOOL ETILICO 70 % ST TP ML 0.0300 0.0200 0.0100 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 11193 CLOREXIDINA 2 % ST TP ML 0.8000 0.0000 0.8000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 11193 CLOREXIDINA 2 % ST TP ML 0.8000 0.0000 0.8000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 11193 CLOREXIDINA 2 % ST TP ML 0.8000 0.2700 0.5300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00817 ALGODAO HIDROFILO BOLINHA UN 0.2600 0.1300 0.1300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 05975 COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER 0.6000 0.0000 0.6000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12558131243 NULL 12558131243 08648 ESPARADRAPO 10 X 4.5 CM CM 0.4000 0.2600 0.1400 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12558131243 NULL 12558131243 08648 ESPARADRAPO 10 X 4.5 CM CM 0.4000 0.2600 0.1400 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12558131243 NULL 12558131243 05975 COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER 0.9000 0.3800 0.5200 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12558131243 NULL 12558131243 08664 ESPARADRAPO MICROPORE 50 X 10 CM CM 0.7700 0.2600 0.5100 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 33936 CEFTRIAXONA IV 1G + DIL. 10 ML PO IV FA 54.1300 0.0000 54.1300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00817 ALGODAO HIDROFILO BOLINHA UN 0.2600 0.1300 0.1300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00817 ALGODAO HIDROFILO BOLINHA UN 0.2600 0.1300 0.1300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 7c2bc8cd9bbf9ce081562a3c63fff8c9 MARTA 12647505849 NULL 12647505849 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1756 0.0044 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 7c2bc8cd9bbf9ce081562a3c63fff8c9 MARTA 12647505849 NULL 12647505849 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1756 0.0044 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 f65f553befc0e3bc8bd5bce5c1c6e413 NAIRLENE 12633078944 NULL 12633078944 19160 SERINGA DESC 20 ML UN 0.5400 0.5367 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 f65f553befc0e3bc8bd5bce5c1c6e413 NAIRLENE 12633078944 NULL 12633078944 19160 SERINGA DESC 20 ML UN 0.5400 0.5367 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 f65f553befc0e3bc8bd5bce5c1c6e413 NAIRLENE 12633078944 NULL 12633078944 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4067 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 f65f553befc0e3bc8bd5bce5c1c6e413 NAIRLENE 12633078944 NULL 12633078944 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1760 0.0040 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 f65f553befc0e3bc8bd5bce5c1c6e413 NAIRLENE 12633078944 NULL 12633078944 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1760 0.0040 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 f65f553befc0e3bc8bd5bce5c1c6e413 NAIRLENE 12633078944 NULL 12633078944 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1760 0.0040 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 f65f553befc0e3bc8bd5bce5c1c6e413 NAIRLENE 12633078944 NULL 12633078944 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1760 0.0040 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 f65f553befc0e3bc8bd5bce5c1c6e413 NAIRLENE 12633078944 NULL 12633078944 07269 DIPIRONA 500 MG/ML 2 ML SI IV IM AP 0.6900 0.6867 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 f65f553befc0e3bc8bd5bce5c1c6e413 NAIRLENE 12633078944 NULL 12633078944 07269 DIPIRONA 500 MG/ML 2 ML SI IV IM AP 0.6900 0.6867 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 f65f553befc0e3bc8bd5bce5c1c6e413 NAIRLENE 12633078944 NULL 12633078944 07269 DIPIRONA 500 MG/ML 2 ML SI IV IM AP 0.6900 0.6867 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 c2bcdc3cbedb73a0db271ac09d4587a1 ORDETE 12694018147 NULL 12694018147 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1760 0.0040 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 f93cee6f501560245a8f94ffc5c6c246 ROSEDALIA 12622895145 NULL 12622895145 19160 SERINGA DESC 20 ML UN 0.5400 0.5373 0.0027 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 026c6dcfddc3d74250c79f449289696a SALOMAO 12456038443 NULL 12456038443 102001 DIARIA DE APARTAMENTO SIMPLES 288.8900 288.8800 0.0000 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 026c6dcfddc3d74250c79f449289696a SALOMAO 12456038443 NULL 12456038443 12262 ISOSSORBIDA 20 MG CP VO UN 0.2200 0.2150 0.0050 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 d4089ccef13567fd45b16fb0b60685fa VERA 12640482546 NULL 12640482546 00035 ABOCATH (CATETER INTRAVENOSO) N. 14 A 22 UN 3.7700 3.7600 0.0000 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 d4089ccef13567fd45b16fb0b60685fa VERA 12640482546 NULL 12640482546 27480 CLARITROMICINA 500 MG 30 ML PO IV FA 117.1100 117.1050 0.0050 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 d4089ccef13567fd45b16fb0b60685fa VERA 12640482546 NULL 12640482546 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1754 0.0046 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 d4089ccef13567fd45b16fb0b60685fa VERA 12640482546 NULL 12640482546 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1754 0.0046 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 d4089ccef13567fd45b16fb0b60685fa VERA 12640482546 NULL 12640482546 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1754 0.0046 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 d4089ccef13567fd45b16fb0b60685fa VERA 12640482546 NULL 12640482546 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1754 0.0046 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 d4089ccef13567fd45b16fb0b60685fa VERA 12640482546 NULL 12640482546 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1754 0.0046 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 d4089ccef13567fd45b16fb0b60685fa VERA 12640482546 NULL 12640482546 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1754 0.0046 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4074 0.0026 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4074 0.0026 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4074 0.0026 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 19160 SERINGA DESC 20 ML UN 0.5400 0.5372 0.0028 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 19160 SERINGA DESC 20 ML UN 0.5400 0.5372 0.0028 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 19160 SERINGA DESC 20 ML UN 0.5400 0.5372 0.0028 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 19160 SERINGA DESC 20 ML UN 0.5400 0.5372 0.0028 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 19160 SERINGA DESC 20 ML UN 0.5400 0.5372 0.0028 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 19160 SERINGA DESC 20 ML UN 0.5400 0.5372 0.0028 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 19160 SERINGA DESC 20 ML UN 0.5400 0.5372 0.0028 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1d6bbb4a00130e2e654e830fc9bae6a ALEXANDRINA 12694224940 NULL 12694224940 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4072 0.0028 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1d6bbb4a00130e2e654e830fc9bae6a ALEXANDRINA 12694224940 NULL 12694224940 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4072 0.0028 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 345c226bfea274af1372d41b0305a6c8 ALTINO 12720257940 NULL 12720257940 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1000 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 345c226bfea274af1372d41b0305a6c8 ALTINO 12720257940 NULL 12720257940 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1000 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 345c226bfea274af1372d41b0305a6c8 ALTINO 12720257940 NULL 12720257940 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1000 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 345c226bfea274af1372d41b0305a6c8 ALTINO 12720257940 NULL 12720257940 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1000 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1038 -0.0038 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1038 -0.0038 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1038 -0.0038 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1038 -0.0038 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1038 -0.0038 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1038 -0.0038 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1038 -0.0038 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1038 -0.0038 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 19160 SERINGA DESC 20 ML UN 0.5400 0.5378 0.0022 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 19160 SERINGA DESC 20 ML UN 0.5400 0.5378 0.0022 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1797 0.0003 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1797 0.0003 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1797 0.0003 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1797 0.0003 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.4000 0.4045 -0.0045 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 08435 EQUIPO P/ BOMBA DE INFUSAO ENTERAL / PARENT 20.2800 20.2780 0.0020 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 20567 SORO FISIOLOGICO 0,9% 500 ML SI IV BS 4.7300 4.7350 -0.0050 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 53660 EQUIPO MACRO-GOTAS FLEXIVEL C/ INJETOR LATE 1.5900 0.0000 1.5900 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 05975 COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER 0.3000 0.0000 0.3000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 05975 COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER 0.6000 0.1500 0.4500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 670141098c0309ac9be3db204bdc12cf LEOSINA 12706525442 NULL 12706525442 02461 FENOTEROL 2 MG/ML 10 ML AE IN DS 0.4300 0.4250 0.0050 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 00817 ALGODAO HIDROFILO BOLINHA UN 0.5100 0.2600 0.2500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 27480 CLARITROMICINA 500 MG 30 ML PO IV FA 117.1100 117.1050 0.0050 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 27480 CLARITROMICINA 500 MG 30 ML PO IV FA 117.1100 117.1050 0.0050 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 07269 DIPIRONA 500 MG/ML 2 ML SI IV IM AP 0.6900 0.6850 0.0050 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1758 0.0042 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1758 0.0042 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1758 0.0042 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1758 0.0042 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4084 0.0016 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4084 0.0016 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4084 0.0016 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4084 0.0016 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4084 0.0016 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4084 0.0016 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4084 0.0016 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 19160 SERINGA DESC 20 ML UN 0.5400 0.5384 0.0016 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 19160 SERINGA DESC 20 ML UN 0.5400 0.5384 0.0016 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 19160 SERINGA DESC 20 ML UN 0.5400 0.5384 0.0016 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 19445 CLORETO DE POTASSIO 600 MG CA VO UN 0.4900 0.4867 0.0033 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 19445 CLORETO DE POTASSIO 600 MG CA VO UN 0.4900 0.4867 0.0033 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 19445 CLORETO DE POTASSIO 600 MG CA VO UN 0.4900 0.4867 0.0033 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4075 0.0025 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4075 0.0025 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4075 0.0025 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4075 0.0025 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 07269 DIPIRONA 500 MG/ML 2 ML SI IV IM AP 0.6900 0.6865 0.0035 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 07269 DIPIRONA 500 MG/ML 2 ML SI IV IM AP 0.6900 0.6865 0.0035 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 07269 DIPIRONA 500 MG/ML 2 ML SI IV IM AP 0.6900 0.6865 0.0035 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 07269 DIPIRONA 500 MG/ML 2 ML SI IV IM AP 0.6900 0.6865 0.0035 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 07269 DIPIRONA 500 MG/ML 2 ML SI IV IM AP 0.6900 0.6865 0.0035 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 07269 DIPIRONA 500 MG/ML 2 ML SI IV IM AP 0.6900 0.6865 0.0035 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 07269 DIPIRONA 500 MG/ML 2 ML SI IV IM AP 0.6900 0.6865 0.0035 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 07269 DIPIRONA 500 MG/ML 2 ML SI IV IM AP 0.6900 0.6865 0.0035 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 07269 DIPIRONA 500 MG/ML 2 ML SI IV IM AP 0.6900 0.6865 0.0035 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 19160 SERINGA DESC 20 ML UN 0.5400 0.5375 0.0025 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 19160 SERINGA DESC 20 ML UN 0.5400 0.5375 0.0025 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1769 0.0031 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1769 0.0031 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1769 0.0031 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1769 0.0031 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8073 0.0027 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 33227 LUVA CIRURGICA PAR UN 1.4500 1.4477 0.0023 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 19160 SERINGA DESC 20 ML UN 0.5400 0.5372 0.0028 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 19160 SERINGA DESC 20 ML UN 0.5400 0.5372 0.0028 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 19160 SERINGA DESC 20 ML UN 0.5400 0.5372 0.0028 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 19160 SERINGA DESC 20 ML UN 0.5400 0.5372 0.0028 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 19160 SERINGA DESC 20 ML UN 0.5400 0.5372 0.0028 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 19160 SERINGA DESC 20 ML UN 0.5400 0.5372 0.0028 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 19160 SERINGA DESC 20 ML UN 0.5400 0.5372 0.0028 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 19160 SERINGA DESC 20 ML UN 0.5400 0.5372 0.0028 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 19160 SERINGA DESC 20 ML UN 0.5400 0.5372 0.0028 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1779 0.0021 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1779 0.0021 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1779 0.0021 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1779 0.0021 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1779 0.0021 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1779 0.0021 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1779 0.0021 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1779 0.0021 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8092 0.0008 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 11193 CLOREXIDINA 2 % ST TP ML 0.5300 0.5320 -0.0020 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 11193 CLOREXIDINA 2 % ST TP ML 0.5300 0.5320 -0.0020 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 08664 ESPARADRAPO MICROPORE 50 X 10 CM CM 0.2600 0.2558 0.0042 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 08664 ESPARADRAPO MICROPORE 50 X 10 CM CM 0.2600 0.2558 0.0042 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e2b254ce765be196b019032789d8f852 MARIA 12576216044 NULL 12576216044 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4078 0.0022 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e2b254ce765be196b019032789d8f852 MARIA 12576216044 NULL 12576216044 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4078 0.0022 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 32891 EQUIPO POLIFIX 2ş VIAS UN 2.5500 2.5500 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 19135 SERINGA DESC 03 ML UN 0.1500 0.0000 0.1500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 19135 SERINGA DESC 03 ML UN 0.1500 0.0000 0.1500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 20559 SORO FISIOLOGICO 0,9% 250 ML SI IV BS 7.8900 3.9400 3.9500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 6ccea6ac8c216c032723aee73a9f81c9 PRISCILA 12662249242 NULL 12662249242 50385 CETOPROFENO 100 MG PO IV FA 7.7800 7.7700 0.0000 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 6ccea6ac8c216c032723aee73a9f81c9 PRISCILA 12662249242 NULL 12662249242 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4067 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 6ccea6ac8c216c032723aee73a9f81c9 PRISCILA 12662249242 NULL 12662249242 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4067 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 6ccea6ac8c216c032723aee73a9f81c9 PRISCILA 12662249242 NULL 12662249242 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4067 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 6ccea6ac8c216c032723aee73a9f81c9 PRISCILA 12662249242 NULL 12662249242 20672 SORO RINGER SIMPLES 500 ML SI IV BS 5.9400 5.9375 0.0025 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 6ccea6ac8c216c032723aee73a9f81c9 PRISCILA 12662249242 NULL 12662249242 07269 DIPIRONA 500 MG/ML 2 ML SI IV IM AP 0.6900 0.6860 0.0040 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 6ccea6ac8c216c032723aee73a9f81c9 PRISCILA 12662249242 NULL 12662249242 07269 DIPIRONA 500 MG/ML 2 ML SI IV IM AP 0.6900 0.6864 0.0036 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 6ccea6ac8c216c032723aee73a9f81c9 PRISCILA 12662249242 NULL 12662249242 19160 SERINGA DESC 20 ML UN 0.5400 0.5373 0.0027 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1000 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1000 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1000 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1000 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1000 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1000 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1000 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1000 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.2100 0.2100 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 33227 LUVA CIRURGICA PAR UN 1.4500 1.4476 0.0024 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 33227 LUVA CIRURGICA PAR UN 1.4500 1.4476 0.0024 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 19151 SERINGA DESC 10 ML UN 0.3300 0.3333 -0.0033 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 19151 SERINGA DESC 10 ML UN 0.3300 0.3333 -0.0033 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 19160 SERINGA DESC 20 ML UN 0.5400 0.5384 0.0016 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 19160 SERINGA DESC 20 ML UN 0.5400 0.5384 0.0016 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 19160 SERINGA DESC 20 ML UN 0.5400 0.5384 0.0016 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 19160 SERINGA DESC 20 ML UN 0.5400 0.5384 0.0016 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 19160 SERINGA DESC 20 ML UN 0.5400 0.5384 0.0016 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1776 0.0024 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1776 0.0024 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1776 0.0024 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1776 0.0024 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1776 0.0024 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1776 0.0024 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8092 0.0008 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8092 0.0008 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 11193 CLOREXIDINA 2 % ST TP ML 0.5300 0.5300 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 6799aa3de305405ab065aad5b599765c VANIR 12700232345 NULL 12700232345 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1750 0.0050 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 0111beed375944f60c7ad4a7fd4874f8 WALDIR 12746025744 NULL 12746025744 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1773 0.0027 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 0111beed375944f60c7ad4a7fd4874f8 WALDIR 12746025744 NULL 12746025744 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1773 0.0027 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 0111beed375944f60c7ad4a7fd4874f8 WALDIR 12746025744 NULL 12746025744 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1773 0.0027 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 05975 COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER 0.3000 0.0000 0.3000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 05975 COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER 0.3000 0.3000 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 05975 COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER 0.3000 0.0000 0.3000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 29661 NOREPINEFRINA 2 MG/ML 4 ML SI IV AP 37.9900 37.9850 0.0050 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8079 0.0021 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8079 0.0021 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 08435 EQUIPO P/ BOMBA DE INFUSAO ENTERAL / PARENT 20.2800 20.2775 0.0025 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 610c198ec4c064687cf0524f147d3aed ROBERTO 12748814743 NULL 12748814743 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1759 0.0041 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 610c198ec4c064687cf0524f147d3aed ROBERTO 12748814743 NULL 12748814743 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1767 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 610c198ec4c064687cf0524f147d3aed ROBERTO 12748814743 NULL 12748814743 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1767 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 610c198ec4c064687cf0524f147d3aed ROBERTO 12748814743 NULL 12748814743 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1767 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 610c198ec4c064687cf0524f147d3aed ROBERTO 12748814743 NULL 12748814743 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1767 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 610c198ec4c064687cf0524f147d3aed ROBERTO 12748814743 NULL 12748814743 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4083 0.0017 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 610c198ec4c064687cf0524f147d3aed ROBERTO 12748814743 NULL 12748814743 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4083 0.0017 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12647284040 NULL 12647284040 07269 DIPIRONA 500 MG/ML 2 ML SI IV IM AP 0.6900 0.6800 0.0000 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12647284040 NULL 12647284040 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4080 0.0020 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12647284040 NULL 12647284040 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1750 0.0050 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12647284040 NULL 12647284040 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1750 0.0050 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12647284040 NULL 12647284040 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1750 0.0050 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12647284040 NULL 12647284040 08664 ESPARADRAPO MICROPORE 50 X 10 CM CM 0.7700 0.7667 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12647284040 NULL 12647284040 08664 ESPARADRAPO MICROPORE 50 X 10 CM CM 0.7700 0.7667 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12647284040 NULL 12647284040 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4086 0.0014 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12647284040 NULL 12647284040 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4086 0.0014 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12647284040 NULL 12647284040 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4086 0.0014 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12647284040 NULL 12647284040 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4086 0.0014 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12647284040 NULL 12647284040 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4086 0.0014 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12647284040 NULL 12647284040 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4086 0.0014 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 08435 EQUIPO P/ BOMBA DE INFUSAO ENTERAL / PARENT 20.2800 20.2775 0.0025 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 08435 EQUIPO P/ BOMBA DE INFUSAO ENTERAL / PARENT 20.2800 20.2775 0.0025 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 08435 EQUIPO P/ BOMBA DE INFUSAO ENTERAL / PARENT 20.2800 20.2775 0.0025 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 33219 LUVA DE PROCEDIMENTO UNIDADE UN 0.3300 0.0000 0.3300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 11193 CLOREXIDINA 2 % ST TP ML 0.5300 0.0000 0.5300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 33588 CLORETO DE SODIO 20% 10 ML SI IV AP 1.1000 1.1250 -0.0250 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 33545 PIPERACILINA 4 G + TAZOBACTAM 500 MG PO IV 83.4500 83.4500 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 6.8145 -3.4045 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 6.8145 -3.4045 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 6.8145 -3.4045 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 6.8145 -3.4045 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 6.8145 -3.4045 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 6.8145 -3.4045 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 6.8145 -3.4045 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4072 0.0028 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4072 0.0028 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4072 0.0028 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4072 0.0028 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4072 0.0028 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 33227 LUVA CIRURGICA PAR UN 2.9000 2.9000 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 33227 LUVA CIRURGICA PAR UN 2.9000 2.9000 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 33227 LUVA CIRURGICA PAR UN 2.9000 2.9000 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 33227 LUVA CIRURGICA PAR UN 2.9000 2.9000 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.2120 -0.1120 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.2120 -0.1120 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.2120 -0.1120 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.2120 -0.1120 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.2120 -0.1120 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 19160 SERINGA DESC 20 ML UN 0.5400 0.5374 0.0026 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 19160 SERINGA DESC 20 ML UN 0.5400 0.5374 0.0026 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 19160 SERINGA DESC 20 ML UN 0.5400 0.5374 0.0026 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 19160 SERINGA DESC 20 ML UN 0.5400 0.5374 0.0026 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.4000 0.4026 -0.0026 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.4000 0.4037 -0.0037 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.4000 0.4037 -0.0037 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.4000 0.4037 -0.0037 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.4000 0.4037 -0.0037 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.4000 0.4037 -0.0037 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.4000 0.4037 -0.0037 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.4000 0.4037 -0.0037 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8073 0.0027 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8073 0.0027 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8073 0.0027 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 13757 IODOPOVIDONA SD TP ML 0.4000 0.4000 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 13757 IODOPOVIDONA SD TP ML 0.4000 0.4000 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 33219 LUVA DE PROCEDIMENTO UNIDADE UN 1.3300 1.3400 -0.0100 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00434 AGUA BIDESTILADA 1000 ML SI IM IV BS 71.2000 80.1000 -71.2000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 09636 FLORATIL (SACCHAROMYCES BOULARDII) 200 MG P 4.4400 8.8851 -4.4451 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 09636 FLORATIL (SACCHAROMYCES BOULARDII) 200 MG P 4.4400 8.8851 -4.4451 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 05975 COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER 1.3439 1.3948 -0.7948 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 28959 DERSANI LC TP ML 12.6100 13.5800 -3.8800 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 08664 ESPARADRAPO MICROPORE 50 X 10 CM CM 1.3564 1.3849 -0.8749 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 08664 ESPARADRAPO MICROPORE 50 X 10 CM CM 1.8664 1.8979 -0.8779 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1d6bbb4a00130e2e654e830fc9bae6a ALEXANDRINA 12694224940 NULL 12694224940 05274 AMOXICILINA 500 MG + CLAVULANATO 125 MG CP 3.1700 3.1667 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 00123 LUVA CIRURGICA UN NULL 0.0000 NULL OPME INVALIDO 2201
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 00123 LUVA CIRURGICA UN NULL 0.0000 NULL OPME INVALIDO 2201
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 00123 LUVA CIRURGICA UN NULL 0.0000 NULL OPME INVALIDO 2201
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 52392 SONDA DE ASPIRAÇAO TRAQUEAL C/ VALVULA UN NULL 0.0000 NULL OPME INVALIDO 2201
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 52733 SERINGA DESC 20 ML UN NULL 0.0000 NULL OPME INVALIDO 2201
Glosa Min 2018-10-03 00:00:00.000000 1084117 800720d33fe0defb6121e82dd216d044 JALMO 12786952647 NULL 12786952647 00501 DRAMIN B6 DL (DIMENIDRINATO + PIRIDOXINA + GLIC. 0.0000 2.2100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 800720d33fe0defb6121e82dd216d044 JALMO 12786952647 NULL 12786952647 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.8100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 800720d33fe0defb6121e82dd216d044 JALMO 12786952647 NULL 12786952647 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 800720d33fe0defb6121e82dd216d044 JALMO 12786952647 NULL 12786952647 00757 CEFUROXIMA 750 MG + DIL. 6 ML PO IM IV FA 0.0000 26.1300 NULL VALOR APRESENTADO A MAIOR 1705
Glosa Min 2018-10-03 00:00:00.000000 1084117 800720d33fe0defb6121e82dd216d044 JALMO 12786952647 NULL 12786952647 00919 ALGODAO HIDROFILO BOLINHA UN 0.0000 0.1300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 752c651cb4fd049e19c685f87fbe8bdc EDUARDO 12765990646 NULL 12765990646 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.2050 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 752c651cb4fd049e19c685f87fbe8bdc EDUARDO 12765990646 NULL 12765990646 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6875 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 752c651cb4fd049e19c685f87fbe8bdc EDUARDO 12765990646 NULL 12765990646 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6875 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 752c651cb4fd049e19c685f87fbe8bdc EDUARDO 12765990646 NULL 12765990646 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6875 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 752c651cb4fd049e19c685f87fbe8bdc EDUARDO 12765990646 NULL 12765990646 53975 Hemifumarato De Quetiapina 25mg ? Cp 0.0000 1.2500 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12558131243 NULL 12558131243 00128 LUVA DE PROCEDIMENTO UNIDADE UN 0.0000 1.0000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12558131243 NULL 12558131243 04259 DRENO DE SUCCAO 0.0000 0.0000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12558131243 NULL 12558131243 52010341 Hérnia Discal - Tratamento Cirúrgico 0.0000 0.0000 NULL COBRANCA DE HONORARIOS EM DUPLICIDADE 2607
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12558131243 NULL 12558131243 52010341 Hérnia Discal - Tratamento Cirúrgico 0.0000 0.0000 NULL COBRANCA DE HONORARIOS EM DUPLICIDADE 2607
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12558131243 NULL 12558131243 52010511 Fratura do Cóccix - Tratamento Cruento 0.0000 0.0000 NULL COBRANCA DE HONORARIOS EM DUPLICIDADE 2607
Glosa Min 2018-10-03 00:00:00.000000 1084117 526685c1041cc1316e874a2e95e67e2e JOSE 12696604949 NULL 12696604949 55060153 Toracotomia com Drenagem Fechada 0.0000 0.0000 NULL COBRANCA DE HONORARIOS EM DUPLICIDADE 2607
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 102001 DIARIA DE APARTAMENTO 0.0000 2888.8800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 11232 CLEXANE (ENOXAPARINA) 40 MG SI IV SC SE 0.0000 38.9400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.0000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.0000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.0000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.0000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 51242 SONDA DOBBHOFF (P/ ALIMENTAÇÃO ENTERAL) UN 0.0000 38.8100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 51379 SERINGA DESC 05 ML UN 0.0000 0.1900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 51379 SERINGA DESC 05 ML UN 0.0000 0.1900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 51434 BECLOMETASONA 400 MCG / ML 2 ML SL IN FL 0.0000 4.4800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 51660 BROMETO DE IPRATROPIO SL IN GT 0.0000 0.0000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00943 EQUIPO POLIFIX 2 VIAS UN 0.0000 5.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 51659 FENOTEROL 2 MG/ML 10 ML AE IN DS 0.0000 0.4300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 4e13adf421809cb755e1bdd80cc4efed AGRIPINA 12385409142 NULL 12385409142 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 4e13adf421809cb755e1bdd80cc4efed AGRIPINA 12385409142 NULL 12385409142 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 4e13adf421809cb755e1bdd80cc4efed AGRIPINA 12385409142 NULL 12385409142 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 4e13adf421809cb755e1bdd80cc4efed AGRIPINA 12385409142 NULL 12385409142 00487 RANITIDINA 25 MG/ML 2 ML SI IM IV AP 0.0000 0.9300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 75bcd473a0dc7c7a6751499b38a4a034 JOAQUIM 12692852143 NULL 12692852143 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4075 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 75bcd473a0dc7c7a6751499b38a4a034 JOAQUIM 12692852143 NULL 12692852143 01652 TRAMADOL 50 MG CP VO UN 0.0000 1.9272 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 75bcd473a0dc7c7a6751499b38a4a034 JOAQUIM 12692852143 NULL 12692852143 01652 TRAMADOL 50 MG CP VO UN 0.0000 1.9272 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 75bcd473a0dc7c7a6751499b38a4a034 JOAQUIM 12692852143 NULL 12692852143 00172 SORO FISIOLOGICO 0,9% 500 ML SI IV BS 0.0000 4.7300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 75bcd473a0dc7c7a6751499b38a4a034 JOAQUIM 12692852143 NULL 12692852143 25030019 Distúrbios Circulatórios Artério - Venosos e Linfáticos 0.0000 45.8500 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 75bcd473a0dc7c7a6751499b38a4a034 JOAQUIM 12692852143 NULL 12692852143 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 75bcd473a0dc7c7a6751499b38a4a034 JOAQUIM 12692852143 NULL 12692852143 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6850 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 75bcd473a0dc7c7a6751499b38a4a034 JOAQUIM 12692852143 NULL 12692852143 00404 LACTULOSE 667 MG/ML XP VO ML 0.0000 4.2900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 75bcd473a0dc7c7a6751499b38a4a034 JOAQUIM 12692852143 NULL 12692852143 04073 TRAMADOL 50 MG 1 ML SI IM IV AP 0.0000 4.1900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 75bcd473a0dc7c7a6751499b38a4a034 JOAQUIM 12692852143 NULL 12692852143 04073 TRAMADOL 50 MG 1 ML SI IM IV AP 0.0000 4.1900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 75bcd473a0dc7c7a6751499b38a4a034 JOAQUIM 12692852143 NULL 12692852143 51710 CLORETO DE POTASSIO 15% 10 ML SI IV AP 0.0000 0.6850 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00124 LUVA CIRURGICA UN 0.0000 1.4475 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00124 LUVA CIRURGICA UN 0.0000 1.4475 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00124 LUVA CIRURGICA UN 0.0000 1.4475 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 24082 BROMOPRIDA 5 MG/ML 2 ML SI IM IV AP 0.0000 2.7300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 26981 SORO FISIOLOGICO 0,9% 10 ML SI IV AP 0.0000 0.9600 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6875 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00487 RANITIDINA 25 MG/ML 2 ML SI IM IV AP 0.0000 0.9300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 54756 HIDANTAL 0.0000 0.1864 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 54756 HIDANTAL 0.0000 0.1864 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 55795 FOSFATO DE POTASSIO 2 MEQ/ML 10 ML SI IV AP 0.0000 3.0200 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00796 FLORATIL (SACCHAROMYCES BOULARDII) 200 MG PO VO 0.0000 4.4400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00796 FLORATIL (SACCHAROMYCES BOULARDII) 200 MG PO VO 0.0000 4.4400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4088 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4088 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4088 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4088 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4088 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4088 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6872 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6872 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1766 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.0000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1766 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1766 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1766 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1766 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1766 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1766 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 00170 SORO GLICOSADO 5% 250 ML SI IV BS 0.0000 6.7800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 22421 PIPERACILINA 2 G + TAZOBACTAM 250 MG 30 ML PO IV 0.0000 55.3400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 22421 PIPERACILINA 2 G + TAZOBACTAM 250 MG 30 ML PO IV 0.0000 55.3400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 22421 PIPERACILINA 2 G + TAZOBACTAM 250 MG 30 ML PO IV 0.0000 55.3400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 22421 PIPERACILINA 2 G + TAZOBACTAM 250 MG 30 ML PO IV 0.0000 55.3400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 22421 PIPERACILINA 2 G + TAZOBACTAM 250 MG 30 ML PO IV 0.0000 55.3400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL COBRANCA DE TAXAS, DE SERVICOS REALIZADOS EM AMBIENTES INCOMPATIVEIS COM O USO DE EQUIPAMENTOS 2407
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 35382 COMPRESSAS DE GASES 7.5 X7,5 (11 FIOS ESTERIL) UN 0.0000 0.3000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 51508 ENCRISE (ARGIPRESSINA) 20 U/ML 1 ML SI IM IV SC AP 0.0000 20.1200 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 51584 ESPARADRAPO MICROPORE 0.0000 0.2560 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 52303 NOREPINEFRINA 2 MG/ML 4 ML SI IV AP 0.0000 218.4200 NULL VALOR APRESENTADO A MAIOR 1705
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 52976 FIO MONONYLON 3-0 C/ AGULHA 2,4 3/8 163T EV 0.0000 4.2581 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cd2840524be5a3f1d0939f241e24f32b MARIA 12705908340 NULL 12705908340 00181 SULFATO DE MAGNESIO 100 MG/ML 10 ML SI IM IV 0.0000 0.9467 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cd2840524be5a3f1d0939f241e24f32b MARIA 12705908340 NULL 12705908340 00184 CLORETO DE POTASSIO 10% 10 ML SI IV AP 0.0000 0.2967 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cd2840524be5a3f1d0939f241e24f32b MARIA 12705908340 NULL 12705908340 00184 CLORETO DE POTASSIO 10% 10 ML SI IV AP 0.0000 0.2967 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cd2840524be5a3f1d0939f241e24f32b MARIA 12705908340 NULL 12705908340 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cd2840524be5a3f1d0939f241e24f32b MARIA 12705908340 NULL 12705908340 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cd2840524be5a3f1d0939f241e24f32b MARIA 12705908340 NULL 12705908340 00090 SERINGA DESC 20 ML UN 0.0000 0.5367 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cd2840524be5a3f1d0939f241e24f32b MARIA 12705908340 NULL 12705908340 00090 SERINGA DESC 20 ML UN 0.0000 0.5367 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1775 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 51660 BROMETO DE IPRATROPIO SL IN GT 0.0000 3.0000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 00090 SERINGA DESC 20 ML UN 0.0000 0.5379 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 01611 CLORETO DE POTASSIO 600 MG CA VO UN 0.0000 0.4867 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 20010150 Ecodoppler de Esforço ou Stress Farmacológico 0.0000 0.0000 NULL EXAME NAO AUTORIZADO 2707
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.8078 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1773 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1773 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1773 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1773 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1773 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4094 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4094 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4094 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 01496 FENITOINA 50 MG/ML 5 ML SI IM IV AP 0.0000 2.3400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 01496 FENITOINA 50 MG/ML 5 ML SI IM IV AP 0.0000 2.3400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 01496 FENITOINA 50 MG/ML 5 ML SI IM IV AP 0.0000 2.3400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 01496 FENITOINA 50 MG/ML 5 ML SI IM IV AP 0.0000 2.3400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 02246 HIDROCORTISONA 100 MG PO IM IV FA 0.0000 2.8300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 02246 HIDROCORTISONA 100 MG PO IM IV FA 0.0000 2.8300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 26981 SORO FISIOLOGICO 0,9% 10 ML SI IV AP 0.0000 0.4800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 26981 SORO FISIOLOGICO 0,9% 10 ML SI IV AP 0.0000 0.4800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 26981 SORO FISIOLOGICO 0,9% 10 ML SI IV AP 0.0000 0.4800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 26981 SORO FISIOLOGICO 0,9% 10 ML SI IV AP 0.0000 0.4800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 26981 SORO FISIOLOGICO 0,9% 10 ML SI IV AP 0.0000 0.9600 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 26981 SORO FISIOLOGICO 0,9% 10 ML SI IV AP 0.0000 0.9600 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 26981 SORO FISIOLOGICO 0,9% 10 ML SI IV AP 0.0000 0.9600 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 26981 SORO FISIOLOGICO 0,9% 10 ML SI IV AP 0.0000 0.9600 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 26981 SORO FISIOLOGICO 0,9% 10 ML SI IV AP 0.0000 0.9600 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 26981 SORO FISIOLOGICO 0,9% 10 ML SI IV AP 0.0000 0.9600 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 52392 SONDA DE ASPIRAÇAO TRAQUEAL C/ VALVULA UN 0.0000 0.9352 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 00069 SERINGA DESC 10 ML UN 0.0000 0.0000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 15f461c0ca379f375bd9f8b18fbb101a ANA 12753753845 NULL 12753753845 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR APRESENTADO A MAIOR 1705
Glosa Min 2018-10-03 00:00:00.000000 1084117 15f461c0ca379f375bd9f8b18fbb101a ANA 12753753845 NULL 12753753845 00657 CEFAZOLINA 1 GR + DIL. 10 ML PO IM IV FA 0.0000 8.1300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 11700 EQUIPO P/ BOMBA DE INFUSAO ENTERAL / PARENTERAL 0.0000 0.0000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00124 LUVA CIRURGICA UN 0.0000 1.4475 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00124 LUVA CIRURGICA UN 0.0000 1.4475 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4072 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4072 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4072 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4072 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4072 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4072 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4072 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4072 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4072 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4072 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4072 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4072 NULL COBRANCA DE MEDICAMENTO EM QUANTIDADE INCOMPATIVEL COM A PERMANENCIA 2107
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4072 NULL VALOR APRESENTADO A MAIOR 1705
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4072 NULL VALOR APRESENTADO A MAIOR 1705
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4072 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4072 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4072 NULL VALOR APRESENTADO A MAIOR 1705
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4072 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 01611 CLORETO DE POTASSIO 600 MG CA VO UN 0.0000 0.4870 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 01611 CLORETO DE POTASSIO 600 MG CA VO UN 0.0000 0.4870 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 01611 CLORETO DE POTASSIO 600 MG CA VO UN 0.0000 0.4870 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 02355 AMOXICILINA 1 G + CLAVULANATO 200 MG + DIL. 10 ML 0.0000 36.4657 NULL COBRANCA DE MEDICAMENTO EM QUANTIDADE INCOMPATIVEL COM A PERMANENCIA 2107
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 02355 AMOXICILINA 1 G + CLAVULANATO 200 MG + DIL. 10 ML 0.0000 36.4667 NULL COBRANCA DE MEDICAMENTO EM QUANTIDADE INCOMPATIVEL COM A PERMANENCIA 2107
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 02355 AMOXICILINA 1 G + CLAVULANATO 200 MG + DIL. 10 ML 0.0000 36.4667 NULL COBRANCA DE MEDICAMENTO EM QUANTIDADE INCOMPATIVEL COM A PERMANENCIA 2107
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 02355 AMOXICILINA 1 G + CLAVULANATO 200 MG + DIL. 10 ML 0.0000 36.4667 NULL COBRANCA DE MEDICAMENTO EM QUANTIDADE INCOMPATIVEL COM A PERMANENCIA 2107
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 02355 AMOXICILINA 1 G + CLAVULANATO 200 MG + DIL. 10 ML 0.0000 36.4667 NULL COBRANCA DE MEDICAMENTO EM QUANTIDADE INCOMPATIVEL COM A PERMANENCIA 2107
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 02355 AMOXICILINA 1 G + CLAVULANATO 200 MG + DIL. 10 ML 0.0000 36.4667 NULL COBRANCA DE MEDICAMENTO EM QUANTIDADE INCOMPATIVEL COM A PERMANENCIA 2107
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 02355 AMOXICILINA 1 G + CLAVULANATO 200 MG + DIL. 10 ML 0.0000 36.4667 NULL COBRANCA DE MEDICAMENTO EM QUANTIDADE INCOMPATIVEL COM A PERMANENCIA 2107
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00090 SERINGA DESC 20 ML UN 0.0000 0.5367 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00090 SERINGA DESC 20 ML UN 0.0000 0.5367 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00090 SERINGA DESC 20 ML UN 0.0000 0.5367 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00090 SERINGA DESC 20 ML UN 0.0000 0.5367 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00090 SERINGA DESC 20 ML UN 0.0000 0.5367 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00090 SERINGA DESC 20 ML UN 0.0000 1.0733 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00090 SERINGA DESC 20 ML UN 0.0000 1.0733 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 2e6b6f291f2df9beb1fbda6028678909 ANNA 12463693448 NULL 12463693448 09070 ACETILCISTEINA 600MG PO VO SA 0.0000 3.5000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 11325 EQUIPO MACRO-GOTAS FLEXIVEL C/ INJETOR LATERAL UN 0.0000 1.5900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00124 LUVA CIRURGICA UN 0.0000 1.4478 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00124 LUVA CIRURGICA UN 0.0000 1.4478 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6871 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6871 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6871 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6871 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 35382 COMPRESSAS DE GASES 7.5 X7,5 (11 FIOS ESTERIL) UN 0.0000 0.3000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00037 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00487 RANITIDINA 25 MG/ML 2 ML SI IM IV AP 0.0000 0.9300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00487 RANITIDINA 25 MG/ML 2 ML SI IM IV AP 0.0000 1.8700 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.4000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.4000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.4000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.4000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1776 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 51649 ALCOOL ETILICO 70 % ST TP ML 0.0000 0.0200 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00090 SERINGA DESC 20 ML UN 0.0000 0.5375 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00090 SERINGA DESC 20 ML UN 0.0000 0.5375 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00090 SERINGA DESC 20 ML UN 0.0000 0.5375 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00090 SERINGA DESC 20 ML UN 0.0000 0.5375 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00090 SERINGA DESC 20 ML UN 0.0000 0.5375 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00090 SERINGA DESC 20 ML UN 0.0000 0.5375 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00090 SERINGA DESC 20 ML UN 0.0000 0.5375 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00090 SERINGA DESC 20 ML UN 0.0000 0.5375 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00090 SERINGA DESC 20 ML UN 0.0000 0.5400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00090 SERINGA DESC 20 ML UN 0.0000 0.5375 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00090 SERINGA DESC 20 ML UN 0.0000 0.5375 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00090 SERINGA DESC 20 ML UN 0.0000 0.5375 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00098 ABOCATH N 14 A 22 UN 0.0000 3.7660 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00098 ABOCATH N 14 A 22 UN 0.0000 3.7660 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ea4ad2636c25d8e3dbb569ae62db71e7 IONE 12489788840 NULL 12489788840 20010141 Ecocardiograma Bidimensional com Mapeamento de Fluxo à Cores 0.0000 0.0000 NULL EXAME SEM REGISTRO DE EXECUCAO 2703
Glosa Min 2018-10-03 00:00:00.000000 1084117 ea4ad2636c25d8e3dbb569ae62db71e7 IONE 12489788840 NULL 12489788840 25040014 Fisioterapia Respiratória - em Doente Clínico Internado 0.0000 10.0600 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 25030019 Distúrbios Circulatórios Artério - Venosos e Linfáticos 0.0000 57.3200 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.8088 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.8074 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.8074 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.8074 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.8074 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.8074 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.8074 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.8074 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1775 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1775 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1775 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1775 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1775 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 51584 ESPARADRAPO MICROPORE 0.0000 0.3800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 51584 ESPARADRAPO MICROPORE 0.0000 0.3800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 51671 REPARIL (ESCINA + DIETILAMONIO) GL TP GR 0.0000 0.0000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 54995 EQUIPO P/ BOMBA DE INFUSAO ENTERAL / PARENTERAL U UN 0.0000 0.0000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 00090 SERINGA DESC 20 ML UN 0.0000 0.5375 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 00090 SERINGA DESC 20 ML UN 0.0000 0.5375 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 00090 SERINGA DESC 20 ML UN 0.0000 0.5375 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 00090 SERINGA DESC 20 ML UN 0.0000 0.5375 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 00090 SERINGA DESC 20 ML UN 0.0000 0.5375 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 00090 SERINGA DESC 20 ML UN 0.0000 0.5375 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 00090 SERINGA DESC 20 ML UN 0.0000 0.5375 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd6f8d6c53ffe9bfd3aa9590ba500cc8 ILDA 12751932542 NULL 12751932542 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.8080 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd6f8d6c53ffe9bfd3aa9590ba500cc8 ILDA 12751932542 NULL 12751932542 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.7000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 00128 LUVA DE PROCEDIMENTO UNIDADE UN 0.0000 0.9987 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 01691 NISTATINA 100.000 UI/ML SU VO ML 0.0000 0.2950 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 01691 NISTATINA 100.000 UI/ML SU VO ML 0.0000 0.2950 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 26981 SORO FISIOLOGICO 0,9% 10 ML SI IV AP 0.0000 0.1400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 26981 SORO FISIOLOGICO 0,9% 10 ML SI IV AP 0.0000 0.1400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 26981 SORO FISIOLOGICO 0,9% 10 ML SI IV AP 0.0000 0.1400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1765 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1765 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1765 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1765 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1765 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 51241 AGULHA 123X45 0.0000 0.1900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 51241 AGULHA 123X45 0.0000 0.1900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 00090 SERINGA DESC 20 ML UN 0.0000 0.5373 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 00090 SERINGA DESC 20 ML UN 0.0000 0.5373 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 61e4786d45edfdbf19b77fb2c6ce6b9c REINALDO 12754482747 NULL 12754482747 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 61e4786d45edfdbf19b77fb2c6ce6b9c REINALDO 12754482747 NULL 12754482747 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 61e4786d45edfdbf19b77fb2c6ce6b9c REINALDO 12754482747 NULL 12754482747 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 61e4786d45edfdbf19b77fb2c6ce6b9c REINALDO 12754482747 NULL 12754482747 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 61e4786d45edfdbf19b77fb2c6ce6b9c REINALDO 12754482747 NULL 12754482747 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 61e4786d45edfdbf19b77fb2c6ce6b9c REINALDO 12754482747 NULL 12754482747 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 61e4786d45edfdbf19b77fb2c6ce6b9c REINALDO 12754482747 NULL 12754482747 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 61e4786d45edfdbf19b77fb2c6ce6b9c REINALDO 12754482747 NULL 12754482747 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 61e4786d45edfdbf19b77fb2c6ce6b9c REINALDO 12754482747 NULL 12754482747 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 61e4786d45edfdbf19b77fb2c6ce6b9c REINALDO 12754482747 NULL 12754482747 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 61e4786d45edfdbf19b77fb2c6ce6b9c REINALDO 12754482747 NULL 12754482747 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 61e4786d45edfdbf19b77fb2c6ce6b9c REINALDO 12754482747 NULL 12754482747 51589 ESPARADRAPO 10 X 4.5 CM CM 0.0000 0.4000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 61e4786d45edfdbf19b77fb2c6ce6b9c REINALDO 12754482747 NULL 12754482747 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 61e4786d45edfdbf19b77fb2c6ce6b9c REINALDO 12754482747 NULL 12754482747 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 61e4786d45edfdbf19b77fb2c6ce6b9c REINALDO 12754482747 NULL 12754482747 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 61e4786d45edfdbf19b77fb2c6ce6b9c REINALDO 12754482747 NULL 12754482747 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 61e4786d45edfdbf19b77fb2c6ce6b9c REINALDO 12754482747 NULL 12754482747 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4072 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4072 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4072 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4072 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4072 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 081fdadb830fb547e83c43fabdb88372 ELZA 12377335349 NULL 12377335349 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 081fdadb830fb547e83c43fabdb88372 ELZA 12377335349 NULL 12377335349 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 081fdadb830fb547e83c43fabdb88372 ELZA 12377335349 NULL 12377335349 01611 CLORETO DE POTASSIO 600 MG CA VO UN 0.0000 0.4900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 081fdadb830fb547e83c43fabdb88372 ELZA 12377335349 NULL 12377335349 01611 CLORETO DE POTASSIO 600 MG CA VO UN 0.0000 0.4900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 081fdadb830fb547e83c43fabdb88372 ELZA 12377335349 NULL 12377335349 01611 CLORETO DE POTASSIO 600 MG CA VO UN 0.0000 0.4900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 081fdadb830fb547e83c43fabdb88372 ELZA 12377335349 NULL 12377335349 02246 HIDROCORTISONA 100 MG PO IM IV FA 0.0000 5.6700 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 081fdadb830fb547e83c43fabdb88372 ELZA 12377335349 NULL 12377335349 02246 HIDROCORTISONA 100 MG PO IM IV FA 0.0000 5.6700 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 081fdadb830fb547e83c43fabdb88372 ELZA 12377335349 NULL 12377335349 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1800 NULL PAGO CONFORME RELATORIO DE AUDITORIA EXTERNA ― CONTA INICIAL 1717
Glosa Min 2018-10-03 00:00:00.000000 1084117 081fdadb830fb547e83c43fabdb88372 ELZA 12377335349 NULL 12377335349 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1800 NULL PAGO CONFORME RELATORIO DE AUDITORIA EXTERNA ― CONTA INICIAL 1717
Glosa Min 2018-10-03 00:00:00.000000 1084117 081fdadb830fb547e83c43fabdb88372 ELZA 12377335349 NULL 12377335349 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 081fdadb830fb547e83c43fabdb88372 ELZA 12377335349 NULL 12377335349 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 081fdadb830fb547e83c43fabdb88372 ELZA 12377335349 NULL 12377335349 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1800 NULL PAGO CONFORME RELATORIO DE AUDITORIA EXTERNA ― CONTA INICIAL 1717
Glosa Min 2018-10-03 00:00:00.000000 1084117 081fdadb830fb547e83c43fabdb88372 ELZA 12377335349 NULL 12377335349 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 081fdadb830fb547e83c43fabdb88372 ELZA 12377335349 NULL 12377335349 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 35382 COMPRESSAS DE GASES 7.5 X7,5 (11 FIOS ESTERIL) UN 0.0000 0.6000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 51379 SERINGA DESC 05 ML UN 0.0000 0.1900 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 51379 SERINGA DESC 05 ML UN 0.0000 0.1900 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 51379 SERINGA DESC 05 ML UN 0.0000 0.1900 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 345c226bfea274af1372d41b0305a6c8 ALTINO 12720257940 NULL 12720257940 00493 BROMOPRIDA 5 MG/ML 2 ML SI IM IV AP 0.0000 2.7300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 345c226bfea274af1372d41b0305a6c8 ALTINO 12720257940 NULL 12720257940 00090 SERINGA DESC 20 ML UN 0.0000 0.5367 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 00128 LUVA DE PROCEDIMENTO UNIDADE UN 0.0000 1.6700 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 00090 SERINGA DESC 20 ML UN 0.0000 0.5400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 00090 SERINGA DESC 20 ML UN 0.0000 0.5400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 00919 ALGODAO HIDROFILO BOLINHA UN 0.0000 0.2600 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 00919 ALGODAO HIDROFILO BOLINHA UN 0.0000 0.2600 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 01652 TRAMADOL 50 MG CP VO UN 0.0000 1.9300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 01652 TRAMADOL 50 MG CP VO UN 0.0000 1.9300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 01652 TRAMADOL 50 MG CP VO UN 0.0000 1.9300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 01652 TRAMADOL 50 MG CP VO UN 0.0000 1.9300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6875 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.8100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 51589 ESPARADRAPO 10 X 4.5 CM CM 0.0000 0.4000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3fb5c891f31bb9efcb05395066127c52 ALAIDE 12636273441 NULL 12636273441 00487 RANITIDINA 25 MG/ML 2 ML SI IM IV AP 0.0000 0.0000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 610c198ec4c064687cf0524f147d3aed ROBERTO 12748814743 NULL 12748814743 16322 BENZILPENICILINA POTASSICA CRIST. 5.000.000 8.0700 8.0683 0.0017 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 610c198ec4c064687cf0524f147d3aed ROBERTO 12748814743 NULL 12748814743 16322 BENZILPENICILINA POTASSICA CRIST. 5.000.000 8.0700 8.0683 0.0017 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 54989 LUFTAL (SIMETICONA) EM VO GT 0.0900 0.0400 0.0500 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 54989 LUFTAL (SIMETICONA) EM VO GT 0.1200 0.0500 0.0700 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 54989 LUFTAL (SIMETICONA) EM VO GT 0.1200 0.0500 0.0700 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00204 AAS (ACIDO ACETILSALICILICO) 100 MG CP VO UN 0.1400 0.0600 0.0800 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 51378 SERINGA DESC 03 ML UN 0.1500 0.0600 0.0900 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 51378 SERINGA DESC 03 ML UN 0.1500 0.0600 0.0900 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.4000 0.1600 0.2400 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.4000 0.1600 0.2400 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.4000 0.1600 0.2400 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.4000 0.1600 0.2400 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.4000 0.1600 0.2400 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.4000 0.1600 0.2400 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 51589 ESPARADRAPO 10 X 4.5 CM CM 0.4000 0.1600 0.2400 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 51589 ESPARADRAPO 10 X 4.5 CM CM 0.4000 0.1600 0.2400 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 54687 IODOPOVIDONA SD TP ML 0.4000 0.1600 0.2400 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 54687 IODOPOVIDONA SD TP ML 0.4000 0.1600 0.2400 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 07802 PIPERACILINA 4 G + TAZOBACTAM 500 MG PO IV FA 83.4500 32.5900 50.8600 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 07802 PIPERACILINA 4 G + TAZOBACTAM 500 MG PO IV FA 83.4500 32.5900 50.8600 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 54178 DIETA SEMI ELEMENTAR C/ IMUNOMODDULADORES 1.5 KCA 115.2000 44.9800 70.2200 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 54178 DIETA SEMI ELEMENTAR C/ IMUNOMODDULADORES 1.5 KCA 115.2000 44.9800 70.2200 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 01081197 edcdbaa61bbaa91565bc29f993979fda JOHN 12767485129 NULL 12767485129 201001 TAXA DE SALA PORTE 0 NULL 0.0000 NULL OPME INVALIDO 2201
Glosa Min 2018-10-03 00:00:00.000000 01081197 2d09719942c3ab57ad7a3a3de0808ecf DEGNES 12660187820 NULL 12660187820 201001 TAXA DE SALA PORTE 0 NULL 0.0000 NULL OPME INVALIDO 2201
Glosa Min 2018-10-03 00:00:00.000000 01081197 3af14fcc4f764a77ed38b3d2e81bcc76 JOAO 12687535922 NULL 12687535922 00171 SORO FISIOLOGICO 0,9% 250 ML SI IV BS NULL 0.0000 NULL OPME INVALIDO 2201
Glosa Min 2018-10-03 00:00:00.000000 1084117 16b1e9f62f247f02ad5cac910ee15b4e BERCHOLINA 12631612848 NULL 12631612848 00171 SORO FISIOLOGICO 0,9% 250 ML SI IV BS 3.9400 3.7600 0.1800 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 16b1e9f62f247f02ad5cac910ee15b4e BERCHOLINA 12631612848 NULL 12631612848 00171 SORO FISIOLOGICO 0,9% 250 ML SI IV BS 3.9400 3.7600 0.1800 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 16b1e9f62f247f02ad5cac910ee15b4e BERCHOLINA 12631612848 NULL 12631612848 04073 TRAMADOL 50 MG 1 ML SI IM IV AP 4.1900 4.0000 0.1900 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 16b1e9f62f247f02ad5cac910ee15b4e BERCHOLINA 12631612848 NULL 12631612848 04073 TRAMADOL 50 MG 1 ML SI IM IV AP 4.1900 3.9900 0.2000 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 16b1e9f62f247f02ad5cac910ee15b4e BERCHOLINA 12631612848 NULL 12631612848 22421 PIPERACILINA 2 G + TAZOBACTAM 250 MG 30 ML PO IV 55.3400 52.7400 2.6000 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 16b1e9f62f247f02ad5cac910ee15b4e BERCHOLINA 12631612848 NULL 12631612848 22421 PIPERACILINA 2 G + TAZOBACTAM 250 MG 30 ML PO IV 55.3400 52.7400 2.6000 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 16b1e9f62f247f02ad5cac910ee15b4e BERCHOLINA 12631612848 NULL 12631612848 22421 PIPERACILINA 2 G + TAZOBACTAM 250 MG 30 ML PO IV 55.3400 52.7400 2.6000 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 01081195 dd5df5cadc0eeb82bb12177ef8c7398c MARIA 12786762615 NULL 12786762615 00010014 CONSULTA EM CONSULTORIO MEDICO 0.0000 50.0000 NULL ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 01081195 fd1931b243a9f689cf3f934c698785ac ADRIANA 12760902918 NULL 12760902918 00010014 CONSULTA EM CONSULTORIO MEDICO 0.0000 0.0000 50.0000 GUIA DE CONSULTA NAO EXECUTADA 0622
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 00817 ALGODAO HIDROFILO BOLINHA UN 0.5100 0.2600 0.2500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 37761 ALCOOL ETILICO 70 % ST TP ML 0.0600 0.0300 0.0300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 00817 ALGODAO HIDROFILO BOLINHA UN 0.5100 0.2600 0.2500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 00485 AGUA BIDESTILADA 500 ML SI IM IV BS 6.4300 0.0000 6.4300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.0000 0.1000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 02720 BOLSA COLETORA (SISTEMA ABERTO) UN 1.2800 0.6400 0.6400 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 d17b3c5ae418d82694895a326dee545a ODILIA 12670516743 NULL 12670516743 33219 LUVA DE PROCEDIMENTO UNIDADE UN 1.0000 0.6700 0.3300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 d17b3c5ae418d82694895a326dee545a ODILIA 12670516743 NULL 12670516743 37761 ALCOOL ETILICO 70 % ST TP ML 0.0300 0.0200 0.0100 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 d17b3c5ae418d82694895a326dee545a ODILIA 12670516743 NULL 12670516743 02461 FENOTEROL 2 MG/ML 10 ML AE IN DS 0.6000 0.0000 0.6000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 d17b3c5ae418d82694895a326dee545a ODILIA 12670516743 NULL 12670516743 02461 FENOTEROL 2 MG/ML 10 ML AE IN DS 0.0900 0.0000 0.0900 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 d17b3c5ae418d82694895a326dee545a ODILIA 12670516743 NULL 12670516743 33219 LUVA DE PROCEDIMENTO UNIDADE UN 1.0000 0.6700 0.3300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 33219 LUVA DE PROCEDIMENTO UNIDADE UN 1.0000 0.6700 0.3300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 00817 ALGODAO HIDROFILO BOLINHA UN 0.2600 0.1300 0.1300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 00817 ALGODAO HIDROFILO BOLINHA UN 0.5100 0.1300 0.3800 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 37761 ALCOOL ETILICO 70 % ST TP ML 0.0600 0.0300 0.0300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 32891 EQUIPO POLIFIX 2ş VIAS UN 7.6500 0.0000 7.6500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 37761 ALCOOL ETILICO 70 % ST TP ML 0.0600 0.0300 0.0300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 53660 EQUIPO MACRO-GOTAS FLEXIVEL C/ INJETOR LATE 6.3500 0.0000 6.3500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 00817 ALGODAO HIDROFILO BOLINHA UN 0.5100 0.2600 0.2500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 22748 LIDOCAINA 2% GE TP OU GR 5.1900 1.3000 3.8900 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 55255 CLEXANE (ENOXAPARINA) 60 MG SI IV SC SE 118.3000 59.1500 59.1500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00817 ALGODAO HIDROFILO BOLINHA UN 0.2600 0.1300 0.1300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00817 ALGODAO HIDROFILO BOLINHA UN 0.2600 0.1300 0.1300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00540 AGULHA DESC 13 X 45 UN 0.7700 0.5800 0.1900 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 27596 TIRA TESTE PARA GLICOSE UN 4.1600 3.1200 1.0400 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.4000 0.4100 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 13757 IODOPOVIDONA SD TP ML 0.6000 0.0000 0.6000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00817 ALGODAO HIDROFILO BOLINHA UN 0.5100 0.2600 0.2500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 37761 ALCOOL ETILICO 70 % ST TP ML 0.0600 0.0300 0.0300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 37761 ALCOOL ETILICO 70 % ST TP ML 0.0600 0.0300 0.0300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 32891 EQUIPO POLIFIX 2ş VIAS UN 5.1000 0.0000 5.1000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 37761 ALCOOL ETILICO 70 % ST TP ML 0.0600 0.0300 0.0300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 33219 LUVA DE PROCEDIMENTO UNIDADE UN 1.0000 0.6700 0.3300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 05975 COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER 0.3000 0.0000 0.3000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 37761 ALCOOL ETILICO 70 % ST TP ML 0.0300 0.0200 0.0100 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 05975 COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER 0.3000 0.0000 0.3000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 08648 ESPARADRAPO 10 X 4.5 CM CM 0.4000 0.2000 0.2000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 37761 ALCOOL ETILICO 70 % ST TP ML 0.0300 0.0200 0.0100 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 05975 COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER 0.3000 0.0000 0.3000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 345c226bfea274af1372d41b0305a6c8 ALTINO 12720257940 NULL 12720257940 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1000 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 345c226bfea274af1372d41b0305a6c8 ALTINO 12720257940 NULL 12720257940 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1000 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 345c226bfea274af1372d41b0305a6c8 ALTINO 12720257940 NULL 12720257940 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1000 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 345c226bfea274af1372d41b0305a6c8 ALTINO 12720257940 NULL 12720257940 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1750 0.0050 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 345c226bfea274af1372d41b0305a6c8 ALTINO 12720257940 NULL 12720257940 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1750 0.0050 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 31d18d6607d9e742c53e748d6a55d740 CARLOS 12557779343 NULL 12557779343 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1760 0.0040 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 31d18d6607d9e742c53e748d6a55d740 CARLOS 12557779343 NULL 12557779343 07269 DIPIRONA 500 MG/ML 2 ML SI IV IM AP 0.6900 0.6860 0.0040 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 0405a686318e3fc262f105ed4be24d95 CARMELITA 12687161644 NULL 12687161644 19160 SERINGA DESC 20 ML UN 0.5400 0.5367 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 0405a686318e3fc262f105ed4be24d95 CARMELITA 12687161644 NULL 12687161644 19160 SERINGA DESC 20 ML UN 0.5400 0.5367 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 752c651cb4fd049e19c685f87fbe8bdc EDUARDO 12765990646 NULL 12765990646 00817 ALGODAO HIDROFILO BOLINHA UN 0.2600 0.0000 0.2600 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 500e4b8f04552b423f9db8f81073659f FIDELIS 12763450340 NULL 12763450340 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1760 0.0040 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 27600 ONDANSETRONA 2 MG/ML 4 ML SI IM IV AP 13.5300 0.0000 13.5300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 19135 SERINGA DESC 03 ML UN 0.1500 0.0000 0.1500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 19135 SERINGA DESC 03 ML UN 0.1500 0.0000 0.1500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 08664 ESPARADRAPO MICROPORE 50 X 10 CM CM 0.2600 0.2563 0.0037 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8075 0.0025 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 02720 BOLSA COLETORA (SISTEMA ABERTO) UN 1.2800 0.9600 0.3200 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 17310 IODOPOVIDONA ALCOOLICA SL TP ML 0.6000 0.0000 0.6000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 02720 BOLSA COLETORA (SISTEMA ABERTO) UN 1.2800 0.0000 1.2800 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 13757 IODOPOVIDONA SD TP ML 0.3000 0.2000 0.1000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 17310 IODOPOVIDONA ALCOOLICA SL TP ML 0.6000 0.0000 0.6000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 17310 IODOPOVIDONA ALCOOLICA SL TP ML 0.6000 0.0000 0.6000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 32204 CLORETO DE SODIO 0,9% 10 ML SI IV AP 0.4800 0.0000 0.4800 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 53660 EQUIPO MACRO-GOTAS FLEXIVEL C/ INJETOR LATE 3.1800 0.0000 3.1800 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 0.0000 3.4100 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 33219 LUVA DE PROCEDIMENTO UNIDADE UN 1.0000 0.6700 0.3300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 00817 ALGODAO HIDROFILO BOLINHA UN 0.2600 0.1300 0.1300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 53660 EQUIPO MACRO-GOTAS FLEXIVEL C/ INJETOR LATE 1.5900 0.0000 1.5900 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 33219 LUVA DE PROCEDIMENTO UNIDADE UN 1.0000 0.6700 0.3300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 33219 LUVA DE PROCEDIMENTO UNIDADE UN 1.0000 0.6700 0.3300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 30376 BROMETO DE IPRATROPIO 0,25MG/ML SL IN GT 2.4000 0.0000 2.4000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 02461 FENOTEROL 2 MG/ML 10 ML AE IN DS 1.0200 0.0000 1.0200 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 30376 BROMETO DE IPRATROPIO 0,25MG/ML SL IN GT 0.4000 0.0000 0.4000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 02461 FENOTEROL 2 MG/ML 10 ML AE IN DS 7.6600 0.0000 7.6600 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 5f044434edae42d3d17c4392018c7824 DINORA 12673932742 NULL 12673932742 37761 ALCOOL ETILICO 70 % ST TP ML 0.0600 0.0000 0.0600 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 d4089ccef13567fd45b16fb0b60685fa VERA 12656425943 NULL 12656425943 33219 LUVA DE PROCEDIMENTO UNIDADE UN 1.0000 0.0000 1.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 19151 SERINGA DESC 10 ML UN 0.3300 0.0000 0.3300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.0000 0.1800 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 37761 ALCOOL ETILICO 70 % ST TP ML 0.0600 0.0300 0.0300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 00817 ALGODAO HIDROFILO BOLINHA UN 0.5100 0.2600 0.2500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 00817 ALGODAO HIDROFILO BOLINHA UN 0.5100 0.2600 0.2500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 37761 ALCOOL ETILICO 70 % ST TP ML 0.0600 0.0300 0.0300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 00817 ALGODAO HIDROFILO BOLINHA UN 0.5100 0.2600 0.2500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 52582 CATETER OXIGENIO TIPO OCULOS UN 1.0000 0.0000 1.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 33219 LUVA DE PROCEDIMENTO UNIDADE UN 1.0000 0.6700 0.3300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 00817 ALGODAO HIDROFILO BOLINHA UN 0.5100 0.2600 0.2500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.0000 0.1800 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cd2840524be5a3f1d0939f241e24f32b MARIA 12705908340 NULL 12705908340 33219 LUVA DE PROCEDIMENTO UNIDADE UN 1.0000 0.6700 0.3300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cd2840524be5a3f1d0939f241e24f32b MARIA 12705908340 NULL 12705908340 00817 ALGODAO HIDROFILO BOLINHA UN 0.2600 0.1300 0.1300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cd2840524be5a3f1d0939f241e24f32b MARIA 12705908340 NULL 12705908340 00817 ALGODAO HIDROFILO BOLINHA UN 0.2600 0.1300 0.1300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12603877940 NULL 12603877940 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.4000 0.0000 0.4000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12603877940 NULL 12603877940 19151 SERINGA DESC 10 ML UN 2.0000 1.6700 0.3300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12603877940 NULL 12603877940 55018 ALGINATO DE CALCIO EM HIDROGEL GL TP GR 20.7000 13.8000 6.9000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12603877940 NULL 12603877940 11193 CLOREXIDINA 2 % ST TP ML 1.0600 0.8000 0.2600 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12603877940 NULL 12603877940 37761 ALCOOL ETILICO 70 % ST TP ML 0.0300 0.0200 0.0100 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12603877940 NULL 12603877940 37761 ALCOOL ETILICO 70 % ST TP ML 0.0300 0.0200 0.0100 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12603877940 NULL 12603877940 11193 CLOREXIDINA 2 % ST TP ML 0.8000 0.0000 0.8000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12603877940 NULL 12603877940 37761 ALCOOL ETILICO 70 % ST TP ML 0.0300 0.0200 0.0100 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12603877940 NULL 12603877940 32204 CLORETO DE SODIO 0,9% 10 ML SI IV AP 1.4400 0.9600 0.4800 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12603877940 NULL 12603877940 33219 LUVA DE PROCEDIMENTO UNIDADE UN 2.0000 0.6700 1.3300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12603877940 NULL 12603877940 27596 TIRA TESTE PARA GLICOSE UN 4.1600 3.1200 1.0400 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12603877940 NULL 12603877940 13757 IODOPOVIDONA SD TP ML 0.4000 0.0000 0.4000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00817 ALGODAO HIDROFILO BOLINHA UN 0.2600 0.1300 0.1300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 05975 COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER 0.3000 0.0000 0.3000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00817 ALGODAO HIDROFILO BOLINHA UN 0.2600 0.1300 0.1300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00817 ALGODAO HIDROFILO BOLINHA UN 0.2600 0.1300 0.1300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 818a6f2e549cc6a60aa20f9d0595eec9 ANTONIO 12565134343 NULL 12565134343 19160 SERINGA DESC 20 ML UN 0.5400 0.5371 0.0029 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 818a6f2e549cc6a60aa20f9d0595eec9 ANTONIO 12565134343 NULL 12565134343 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1765 0.0035 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 818a6f2e549cc6a60aa20f9d0595eec9 ANTONIO 12565134343 NULL 12565134343 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1767 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 a050ed50115d2a6dd0b15b99b39063da ARI 12676101147 NULL 12676101147 11304 HIDROCORTISONA 500 MG PO IM IV FA 6.3500 6.3400 0.0000 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 a050ed50115d2a6dd0b15b99b39063da ARI 12676101147 NULL 12676101147 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1750 0.0050 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 a050ed50115d2a6dd0b15b99b39063da ARI 12676101147 NULL 12676101147 19160 SERINGA DESC 20 ML UN 0.5400 0.5367 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 a050ed50115d2a6dd0b15b99b39063da ARI 12676101147 NULL 12676101147 19160 SERINGA DESC 20 ML UN 0.5400 0.5367 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 a050ed50115d2a6dd0b15b99b39063da ARI 12676101147 NULL 12676101147 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4067 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 a050ed50115d2a6dd0b15b99b39063da ARI 12676101147 NULL 12676101147 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4067 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 a050ed50115d2a6dd0b15b99b39063da ARI 12676101147 NULL 12676101147 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4067 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 edffb7fef608512400078fdf75991573 CARLA 12728631049 NULL 12728631049 32190 CLORETO DE POTASSIO 10% 10 ML SI IV AP 0.3000 0.2900 0.0000 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 edffb7fef608512400078fdf75991573 CARLA 12728631049 NULL 12728631049 19160 SERINGA DESC 20 ML UN 0.5400 0.5300 0.0000 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 edffb7fef608512400078fdf75991573 CARLA 12728631049 NULL 12728631049 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1760 0.0040 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 39df67956a358bf1eab89803158d25dd HELENA 12655863342 NULL 12655863342 20672 SORO RINGER SIMPLES 500 ML SI IV BS 5.9400 5.9300 0.0000 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 39df67956a358bf1eab89803158d25dd HELENA 12655863342 NULL 12655863342 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1750 0.0050 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 39df67956a358bf1eab89803158d25dd HELENA 12655863342 NULL 12655863342 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1750 0.0050 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 39df67956a358bf1eab89803158d25dd HELENA 12655863342 NULL 12655863342 33219 LUVA DE PROCEDIMENTO UNIDADE UN 1.6700 1.6647 0.0053 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 4668d2494ed6c4b2d18be299efcb26a2 JOAO 12469689344 NULL 12469689344 08664 ESPARADRAPO MICROPORE 50 X 10 CM CM 1.0200 0.2600 0.7600 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 00817 ALGODAO HIDROFILO BOLINHA UN 0.7600 0.2600 0.5000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 01081195 5b1e846d62341272eec7cc65f2fed2e7 ANGELIA 12734665810 NULL 12734665810 00010014 CONSULTA EM CONSULTORIO MEDICO 0.0000 35.0000 NULL ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 01081195 3571a431fcd5a8ae3aaed00994dd4300 DARIO 12737609412 NULL 12737609412 00010014 CONSULTA EM CONSULTORIO MEDICO 0.0000 35.0000 NULL ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 01081197 3af14fcc4f764a77ed38b3d2e81bcc76 JOAO 12687535922 NULL 12687535922 34010130 TOMOGRAFIA COMPUTADORIZADA DO TORAX 0.0000 280.6875 NULL ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 2a79bf9d53875b480086bd7b8321c4f1 JOSE 12641066643 NULL 12641066643 25040014 ASSISTENCIA FISIATRICA RESPIRATORIA 0.0000 15.0800 NULL ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 25040014 ASSISTENCIA FISIATRICA RESPIRATORIA 0.0000 55.3100 NULL ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 6799aa3de305405ab065aad5b599765c VANIR 12700232345 NULL 12700232345 25040014 ASSISTENCIA FISIATRICA RESPIRATORIA 0.0000 10.0600 NULL ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1770 0.0030 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1770 0.0030 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8072 0.0028 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8072 0.0028 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8072 0.0028 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 09733 ACETILCISTEINA 600MG PO VO SA 3.5000 3.4940 0.0060 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 09733 ACETILCISTEINA 600MG PO VO SA 3.5000 3.4955 0.0045 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 09733 ACETILCISTEINA 600MG PO VO SA 3.5000 3.4955 0.0045 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 08664 ESPARADRAPO MICROPORE 50 X 10 CM CM 0.2600 0.2561 0.0039 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 08664 ESPARADRAPO MICROPORE 50 X 10 CM CM 0.7700 0.7682 0.0018 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 08664 ESPARADRAPO MICROPORE 50 X 10 CM CM 0.7700 0.7682 0.0018 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 37761 ALCOOL ETILICO 70 % ST TP ML 0.0200 0.0150 0.0050 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 20672 SORO RINGER SIMPLES 500 ML SI IV BS 5.9400 5.9367 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 22896 CEFUROXIMA 750 MG + DIL. 6 ML PO IM IV FA 26.1300 26.1274 0.0026 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 22896 CEFUROXIMA 750 MG + DIL. 6 ML PO IM IV FA 26.1300 26.1271 0.0029 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 42358 FUROSEMIDA 10 MG/ML 2 ML SI IM IV AP 0.6000 0.5986 0.0014 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4078 0.0022 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4078 0.0022 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4078 0.0022 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4078 0.0022 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4078 0.0022 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4078 0.0022 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 33227 LUVA CIRURGICA PAR UN 1.4500 1.4476 0.0024 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 33227 LUVA CIRURGICA PAR UN 1.4500 1.4476 0.0024 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 33227 LUVA CIRURGICA PAR UN 1.4500 1.4476 0.0024 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 33227 LUVA CIRURGICA PAR UN 1.4500 1.4476 0.0024 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 33227 LUVA CIRURGICA PAR UN 1.4500 1.4476 0.0024 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 33227 LUVA CIRURGICA PAR UN 1.4500 1.4476 0.0024 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1038 -0.0038 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1038 -0.0038 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 b288bbcfb9aecab51bcb0dba62ca0059 IVONETE 12743730847 NULL 12743730847 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4067 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 b288bbcfb9aecab51bcb0dba62ca0059 IVONETE 12743730847 NULL 12743730847 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4067 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 b288bbcfb9aecab51bcb0dba62ca0059 IVONETE 12743730847 NULL 12743730847 19160 SERINGA DESC 20 ML UN 0.5400 0.5367 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 b288bbcfb9aecab51bcb0dba62ca0059 IVONETE 12743730847 NULL 12743730847 19160 SERINGA DESC 20 ML UN 0.5400 0.5367 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12558131243 NULL 12558131243 33219 LUVA DE PROCEDIMENTO UNIDADE UN 0.6700 0.6680 0.0020 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 11193 CLOREXIDINA 2 % ST TP ML 0.5300 0.0000 0.5300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 05975 COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER 0.3000 0.0000 0.3000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 32891 EQUIPO POLIFIX 2ş VIAS UN 2.5500 0.0000 2.5500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4084 0.0016 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4084 0.0016 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4084 0.0016 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4084 0.0016 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4084 0.0016 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4084 0.0016 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4084 0.0016 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4084 0.0016 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4084 0.0016 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4084 0.0016 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4084 0.0016 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 2a79bf9d53875b480086bd7b8321c4f1 JOSE 12641066643 NULL 12641066643 12262 ISOSSORBIDA 20 MG CP VO UN 0.2200 0.2165 0.0035 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 2a79bf9d53875b480086bd7b8321c4f1 JOSE 12641066643 NULL 12641066643 12262 ISOSSORBIDA 20 MG CP VO UN 0.2200 0.2167 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 2a79bf9d53875b480086bd7b8321c4f1 JOSE 12641066643 NULL 12641066643 12262 ISOSSORBIDA 20 MG CP VO UN 0.2200 0.2167 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4074 0.0026 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 670141098c0309ac9be3db204bdc12cf LEOSINA 12706525442 NULL 12706525442 08664 ESPARADRAPO MICROPORE 50 X 10 CM CM 0.7700 0.7600 0.0000 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 19160 SERINGA DESC 20 ML UN 0.5400 0.5384 0.0016 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 02461 FENOTEROL 2 MG/ML 10 ML AE IN DS 0.3400 0.0000 0.3400 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 32204 CLORETO DE SODIO 0,9% 10 ML SI IV AP 0.4800 0.4800 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 32204 CLORETO DE SODIO 0,9% 10 ML SI IV AP 0.4800 0.0000 0.4800 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8067 0.0033 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8067 0.0033 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8067 0.0033 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8067 0.0033 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8067 0.0033 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8067 0.0033 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8067 0.0033 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8067 0.0033 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8067 0.0033 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 32204 CLORETO DE SODIO 0,9% 10 ML SI IV AP 0.4800 0.0000 0.4800 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 32204 CLORETO DE SODIO 0,9% 10 ML SI IV AP 0.4800 0.4800 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 32204 CLORETO DE SODIO 0,9% 10 ML SI IV AP 0.4800 0.4800 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 32204 CLORETO DE SODIO 0,9% 10 ML SI IV AP 0.9600 0.9600 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 32204 CLORETO DE SODIO 0,9% 10 ML SI IV AP 0.9600 0.9600 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 32204 CLORETO DE SODIO 0,9% 10 ML SI IV AP 0.4800 0.0000 0.4800 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 32204 CLORETO DE SODIO 0,9% 10 ML SI IV AP 0.9600 0.0000 0.9600 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 32891 EQUIPO POLIFIX 2ş VIAS UN 2.5500 0.0000 2.5500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 32891 EQUIPO POLIFIX 2ş VIAS UN 2.5500 0.0000 2.5500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 32204 CLORETO DE SODIO 0,9% 10 ML SI IV AP 0.4800 0.0000 0.4800 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 32204 CLORETO DE SODIO 0,9% 10 ML SI IV AP 0.4800 0.0000 0.4800 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 32204 CLORETO DE SODIO 0,9% 10 ML SI IV AP 0.4800 0.0000 0.4800 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 32204 CLORETO DE SODIO 0,9% 10 ML SI IV AP 0.4800 0.0000 0.4800 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e715e2ae28a6229c8609756d3298bf52 MARIA 12734221144 NULL 12734221144 00035 ABOCATH (CATETER INTRAVENOSO) N. 14 A 22 UN 3.7700 3.7600 0.0000 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e715e2ae28a6229c8609756d3298bf52 MARIA 12734221144 NULL 12734221144 30511 CEFALOTINA 1 G FA + DIL. 10 ML FA 4.6600 4.6550 0.0050 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e715e2ae28a6229c8609756d3298bf52 MARIA 12734221144 NULL 12734221144 30511 CEFALOTINA 1 G FA + DIL. 10 ML FA 4.6600 4.6550 0.0050 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 11193 CLOREXIDINA 2 % ST TP ML 0.2700 0.2650 0.0050 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 11193 CLOREXIDINA 2 % ST TP ML 0.5300 0.0000 0.5300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 33537 PIPERACILINA 2 G + TAZOBACTAM 250 MG 30 ML 55.3400 55.3375 0.0025 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 33537 PIPERACILINA 2 G + TAZOBACTAM 250 MG 30 ML 55.3400 55.3375 0.0025 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 33537 PIPERACILINA 2 G + TAZOBACTAM 250 MG 30 ML 55.3400 55.3375 0.0025 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4061 0.0039 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4061 0.0039 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4061 0.0039 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4061 0.0039 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 33227 LUVA CIRURGICA PAR UN 1.4500 2.8955 -1.4455 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 33227 LUVA CIRURGICA PAR UN 1.4500 2.8955 -1.4455 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 33227 LUVA CIRURGICA PAR UN 1.4500 1.4477 0.0023 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 33227 LUVA CIRURGICA PAR UN 1.4500 1.4477 0.0023 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 33227 LUVA CIRURGICA PAR UN 1.4500 1.4477 0.0023 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 33227 LUVA CIRURGICA PAR UN 1.4500 1.4477 0.0023 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 33227 LUVA CIRURGICA PAR UN 1.4500 1.4477 0.0023 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 33227 LUVA CIRURGICA PAR UN 1.4500 1.4477 0.0023 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 33227 LUVA CIRURGICA PAR UN 1.4500 1.4477 0.0023 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 19135 SERINGA DESC 03 ML UN 0.1500 0.0000 0.1500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 19135 SERINGA DESC 03 ML UN 0.1500 0.0000 0.1500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 19135 SERINGA DESC 03 ML UN 0.1500 0.0000 0.1500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 19135 SERINGA DESC 03 ML UN 0.1500 0.0000 0.1500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 08664 ESPARADRAPO MICROPORE 50 X 10 CM CM 0.7700 0.2550 0.5150 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.2100 0.2057 0.0043 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.2100 0.2057 0.0043 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.2100 0.2057 0.0043 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1772 0.0028 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1772 0.0028 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1772 0.0028 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1772 0.0028 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1772 0.0028 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1772 0.0028 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1772 0.0028 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cd2840524be5a3f1d0939f241e24f32b MARIA 12705908340 NULL 12705908340 32204 CLORETO DE SODIO 0,9% 10 ML SI IV AP 0.4800 0.4800 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cd2840524be5a3f1d0939f241e24f32b MARIA 12705908340 NULL 12705908340 33219 LUVA DE PROCEDIMENTO UNIDADE UN 0.3300 0.0000 0.3300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cd2840524be5a3f1d0939f241e24f32b MARIA 12705908340 NULL 12705908340 30376 BROMETO DE IPRATROPIO 0,25MG/ML SL IN GT 0.4000 0.0000 0.4000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cd2840524be5a3f1d0939f241e24f32b MARIA 12705908340 NULL 12705908340 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1768 0.0032 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cd2840524be5a3f1d0939f241e24f32b MARIA 12705908340 NULL 12705908340 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1764 0.0036 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cd2840524be5a3f1d0939f241e24f32b MARIA 12705908340 NULL 12705908340 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1764 0.0036 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cd2840524be5a3f1d0939f241e24f32b MARIA 12705908340 NULL 12705908340 02461 FENOTEROL 2 MG/ML 10 ML AE IN DS 0.4300 0.0000 0.4300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 d17b3c5ae418d82694895a326dee545a ODILIA 12670516743 NULL 12670516743 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1768 0.0032 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 d17b3c5ae418d82694895a326dee545a ODILIA 12670516743 NULL 12670516743 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1774 0.0026 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1766 0.0034 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 8a5ecfde671848d05ac757e0112e689c TEREZINHA 12700337042 NULL 12700337042 57258 FUMARATO DE QUETIAPINA 25 MG CA VO UN 1.2500 1.2450 0.0050 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 8a5ecfde671848d05ac757e0112e689c TEREZINHA 12700337042 NULL 12700337042 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4071 0.0029 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 8a5ecfde671848d05ac757e0112e689c TEREZINHA 12700337042 NULL 12700337042 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4071 0.0029 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 8a5ecfde671848d05ac757e0112e689c TEREZINHA 12700337042 NULL 12700337042 19160 SERINGA DESC 20 ML UN 0.5400 0.5376 0.0024 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 8a5ecfde671848d05ac757e0112e689c TEREZINHA 12700337042 NULL 12700337042 19160 SERINGA DESC 20 ML UN 0.5400 0.5376 0.0024 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 8a5ecfde671848d05ac757e0112e689c TEREZINHA 12700337042 NULL 12700337042 19160 SERINGA DESC 20 ML UN 0.5400 0.5376 0.0024 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 8a5ecfde671848d05ac757e0112e689c TEREZINHA 12700337042 NULL 12700337042 19160 SERINGA DESC 20 ML UN 0.5400 0.5376 0.0024 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 70cf23c63f890f0b61da2542c3e13a09 TIAGO 12741864645 NULL 12741864645 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1762 0.0038 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 70cf23c63f890f0b61da2542c3e13a09 TIAGO 12741864645 NULL 12741864645 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1762 0.0038 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 70cf23c63f890f0b61da2542c3e13a09 TIAGO 12741864645 NULL 12741864645 19160 SERINGA DESC 20 ML UN 0.5400 0.5367 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 32204 CLORETO DE SODIO 0,9% 10 ML SI IV AP 0.4800 0.0000 0.4800 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 05975 COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER 0.3000 0.1857 0.1143 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4070 0.0030 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 0111beed375944f60c7ad4a7fd4874f8 WALDIR 12746025744 NULL 12746025744 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8074 0.0026 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 0111beed375944f60c7ad4a7fd4874f8 WALDIR 12746025744 NULL 12746025744 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 1.6200 1.6147 0.0053 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 0111beed375944f60c7ad4a7fd4874f8 WALDIR 12746025744 NULL 12746025744 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 1.6200 1.6147 0.0053 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 0111beed375944f60c7ad4a7fd4874f8 WALDIR 12746025744 NULL 12746025744 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 1.6200 1.6147 0.0053 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 0111beed375944f60c7ad4a7fd4874f8 WALDIR 12746025744 NULL 12746025744 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 1.6200 1.6147 0.0053 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 0111beed375944f60c7ad4a7fd4874f8 WALDIR 12746025744 NULL 12746025744 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4076 0.0024 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 0111beed375944f60c7ad4a7fd4874f8 WALDIR 12746025744 NULL 12746025744 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4076 0.0024 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 0111beed375944f60c7ad4a7fd4874f8 WALDIR 12746025744 NULL 12746025744 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4076 0.0024 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 0111beed375944f60c7ad4a7fd4874f8 WALDIR 12746025744 NULL 12746025744 19160 SERINGA DESC 20 ML UN 0.5400 0.5379 0.0021 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 0111beed375944f60c7ad4a7fd4874f8 WALDIR 12746025744 NULL 12746025744 19160 SERINGA DESC 20 ML UN 0.5400 0.5379 0.0021 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 37761 ALCOOL ETILICO 70 % ST TP ML 0.0300 0.0000 0.0300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 00817 ALGODAO HIDROFILO BOLINHA UN 0.5100 0.2600 0.2500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 00817 ALGODAO HIDROFILO BOLINHA UN 0.5100 0.0000 0.5100 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 27596 TIRA TESTE PARA GLICOSE UN 1.0400 1.0400 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 27596 TIRA TESTE PARA GLICOSE UN 1.0400 1.0400 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 27596 TIRA TESTE PARA GLICOSE UN 1.0400 1.0400 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 27596 TIRA TESTE PARA GLICOSE UN 1.0400 1.0400 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 27596 TIRA TESTE PARA GLICOSE UN 1.0400 1.0400 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12647284040 NULL 12647284040 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4086 0.0014 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12647284040 NULL 12647284040 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4086 0.0014 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12647284040 NULL 12647284040 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4086 0.0014 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12662414945 NULL 12662414945 19445 CLORETO DE POTASSIO 600 MG CA VO UN 0.4900 0.4867 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12662414945 NULL 12662414945 42358 FUROSEMIDA 10 MG/ML 2 ML SI IM IV AP 0.6000 0.5982 0.0018 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12662414945 NULL 12662414945 42358 FUROSEMIDA 10 MG/ML 2 ML SI IM IV AP 0.6000 0.5983 0.0017 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12662414945 NULL 12662414945 42358 FUROSEMIDA 10 MG/ML 2 ML SI IM IV AP 1.2000 1.1967 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12662414945 NULL 12662414945 42358 FUROSEMIDA 10 MG/ML 2 ML SI IM IV AP 1.2000 1.1967 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12662414945 NULL 12662414945 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4064 0.0036 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12662414945 NULL 12662414945 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4071 0.0029 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12662414945 NULL 12662414945 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4071 0.0029 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 05975 COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER 0.3000 0.0000 0.3000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 05975 COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER 0.3000 0.3000 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 05975 COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER 0.3000 0.0000 0.3000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 33227 LUVA CIRURGICA PAR UN 1.4500 1.4476 0.0024 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 33227 LUVA CIRURGICA PAR UN 1.4500 1.4476 0.0024 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 33227 LUVA CIRURGICA PAR UN 1.4500 1.4476 0.0024 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 33227 LUVA CIRURGICA PAR UN 1.4500 1.4476 0.0024 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1770 0.0030 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1770 0.0030 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 00124 LUVA CIRURGICA UN NULL 0.0000 NULL OPME INVALIDO 2201
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 27042 CLOREXIDINA 2 % ST TP ML DEGERMANTE NULL 0.0000 NULL OPME INVALIDO 2201
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 00481 PROTAMINA 1000 UI/ML 5 ML SI IV AP NULL 0.0000 NULL OPME INVALIDO 2201
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 37761 ALCOOL ETILICO 70 % ST TP ML 0.0300 0.0200 0.0100 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00817 ALGODAO HIDROFILO BOLINHA UN 0.2600 0.0000 0.2600 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 32204 CLORETO DE SODIO 0,9% 10 ML SI IV AP 0.4800 0.0000 0.4800 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00817 ALGODAO HIDROFILO BOLINHA UN 0.2600 0.1300 0.1300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.2120 -0.1120 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.2120 -0.1120 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.2120 -0.1120 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.2120 -0.1120 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.2120 -0.1120 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.2120 -0.1120 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.2120 -0.1120 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.2120 -0.1120 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.2120 -0.1120 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.2120 -0.1120 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1060 -0.0060 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1060 -0.0060 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1060 -0.0060 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1060 -0.0060 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1060 -0.0060 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1060 -0.0060 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1060 -0.0060 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1060 -0.0060 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1060 -0.0060 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1060 -0.0060 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 34827 TIORFAN (RACECADOTRILA) 100 MG CA VO UN 3.2000 6.4000 -3.2000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 34827 TIORFAN (RACECADOTRILA) 100 MG CA VO UN 3.2000 6.4000 -3.2000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 34827 TIORFAN (RACECADOTRILA) 100 MG CA VO UN 3.2000 6.4000 -3.2000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 27596 TIRA TESTE PARA GLICOSE UN 1.0400 1.0400 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 27596 TIRA TESTE PARA GLICOSE UN 1.0400 1.0400 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 19160 SERINGA DESC 20 ML UN 0.5400 0.5374 0.0026 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 19160 SERINGA DESC 20 ML UN 0.5400 0.5374 0.0026 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 19445 CLORETO DE POTASSIO 600 MG CA VO UN 1.4637 1.9474 -1.4574 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 19445 CLORETO DE POTASSIO 600 MG CA VO UN 0.9768 1.4605 -0.9705 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 31585 RANITIDINA 25 MG/ML 2 ML SI IV IM AP 0.9300 1.8668 -0.9368 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 31585 RANITIDINA 25 MG/ML 2 ML SI IV IM AP 0.9300 0.9334 -0.0034 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 31585 RANITIDINA 25 MG/ML 2 ML SI IV IM AP 0.9300 0.9334 -0.0034 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 19151 SERINGA DESC 10 ML UN 0.6634 1.0003 -0.6703 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 19151 SERINGA DESC 10 ML UN 0.6634 1.0003 -0.6703 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 19151 SERINGA DESC 10 ML UN 0.3300 0.6669 -0.3369 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 19151 SERINGA DESC 10 ML UN 0.3300 0.6669 -0.3369 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 19151 SERINGA DESC 10 ML UN 0.3300 0.6669 -0.3369 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 19151 SERINGA DESC 10 ML UN 0.3300 0.6669 -0.3369 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 19151 SERINGA DESC 10 ML UN 0.3300 0.6669 -0.3369 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 19151 SERINGA DESC 10 ML UN 0.3300 0.6669 -0.3369 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 19151 SERINGA DESC 10 ML UN 0.3300 0.6669 -0.3369 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00817 ALGODAO HIDROFILO BOLINHA UN 0.2860 0.3120 -0.0520 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00817 ALGODAO HIDROFILO BOLINHA UN 0.2860 0.3120 -0.0520 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 37761 ALCOOL ETILICO 70 % ST TP ML 0.0631 0.0695 -0.0395 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 53660 EQUIPO MACRO-GOTAS FLEXIVEL C/ INJETOR LATE 1.5900 3.1800 -1.5900 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 53660 EQUIPO MACRO-GOTAS FLEXIVEL C/ INJETOR LATE 1.5900 1.5900 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 53660 EQUIPO MACRO-GOTAS FLEXIVEL C/ INJETOR LATE 1.5900 1.5900 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 21822 TRAMADOL 50 MG 1 ML SI IM IV AP 25.1571 29.3540 -25.1640 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 11193 CLOREXIDINA 2 % ST TP ML 0.5300 0.5320 -0.0020 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 11193 CLOREXIDINA 2 % ST TP ML 0.5300 0.5320 -0.0020 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 800720d33fe0defb6121e82dd216d044 JALMO 12786952647 NULL 12786952647 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 0.0000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4075 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00171 SORO FISIOLOGICO 0,9% 250 ML SI IV BS 0.0000 3.9400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 02246 HIDROCORTISONA 100 MG PO IM IV FA 0.0000 0.0000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 02246 HIDROCORTISONA 100 MG PO IM IV FA 0.0000 5.6689 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 26981 SORO FISIOLOGICO 0,9% 10 ML SI IV AP 0.0000 0.9600 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00613 CLINDAMICINA 600 MG 4 ML SI IM IV AP 0.0000 13.0800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00613 CLINDAMICINA 600 MG 4 ML SI IM IV AP 0.0000 13.0800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00069 SERINGA DESC 10 ML UN 0.0000 0.0000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00069 SERINGA DESC 10 ML UN 0.0000 0.0000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00735 CEFTRIAXONA IV 1G + DIL. 10 ML PO IV FA 0.0000 27.0600 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00735 CEFTRIAXONA IV 1G + DIL. 10 ML PO IV FA 0.0000 54.1300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00735 CEFTRIAXONA IV 1G + DIL. 10 ML PO IV FA 0.0000 54.1300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 07802 PIPERACILINA 4 G + TAZOBACTAM 500 MG PO IV FA 0.0000 83.4500 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 07802 PIPERACILINA 4 G + TAZOBACTAM 500 MG PO IV FA 0.0000 83.4500 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 07802 PIPERACILINA 4 G + TAZOBACTAM 500 MG PO IV FA 0.0000 83.4500 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 07802 PIPERACILINA 4 G + TAZOBACTAM 500 MG PO IV FA 0.0000 83.4500 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 08829 Bricanyl 0,5mg Inj. Ampola C/ 1ml 0.0000 3.5900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 08829 Bricanyl 0,5mg Inj. Ampola C/ 1ml 0.0000 3.5900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 09071 ACETILCISTEINA 600MG PO VO SA 0.0000 3.4950 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 09071 ACETILCISTEINA 600MG PO VO SA 0.0000 3.4950 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00090 SERINGA DESC 20 ML UN 0.0000 0.0000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00124 LUVA CIRURGICA UN 0.0000 1.4475 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00124 LUVA CIRURGICA UN 0.0000 1.4475 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00124 LUVA CIRURGICA UN 0.0000 1.4475 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4062 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4062 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4062 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4062 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4062 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4062 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4062 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 01584 NEOSTIGMINA 0,5 MG/ML 1 ML SI IM IV SC AP 0.0000 0.7667 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00170 SORO GLICOSADO 5% 250 ML SI IV BS 0.0000 3.4000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 24082 BROMOPRIDA 5 MG/ML 2 ML SI IM IV AP 0.0000 2.7300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 24082 BROMOPRIDA 5 MG/ML 2 ML SI IM IV AP 0.0000 2.7300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 24082 BROMOPRIDA 5 MG/ML 2 ML SI IM IV AP 0.0000 2.7300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 24082 BROMOPRIDA 5 MG/ML 2 ML SI IM IV AP 0.0000 2.7300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 24082 BROMOPRIDA 5 MG/ML 2 ML SI IM IV AP 0.0000 2.7300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 24082 BROMOPRIDA 5 MG/ML 2 ML SI IM IV AP 0.0000 2.7300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 24082 BROMOPRIDA 5 MG/ML 2 ML SI IM IV AP 0.0000 2.7300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00943 EQUIPO POLIFIX 2 VIAS UN 0.0000 2.5500 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4088 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1766 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1766 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1766 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00090 SERINGA DESC 20 ML UN 0.0000 0.5387 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00090 SERINGA DESC 20 ML UN 0.0000 0.5387 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00090 SERINGA DESC 20 ML UN 0.0000 0.0000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00090 SERINGA DESC 20 ML UN 0.0000 0.5387 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00090 SERINGA DESC 20 ML UN 0.0000 0.5387 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00090 SERINGA DESC 20 ML UN 0.0000 0.5387 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00090 SERINGA DESC 20 ML UN 0.0000 0.5387 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00090 SERINGA DESC 20 ML UN 0.0000 0.5387 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00090 SERINGA DESC 20 ML UN 0.0000 0.5387 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00090 SERINGA DESC 20 ML UN 0.0000 0.5387 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00090 SERINGA DESC 20 ML UN 0.0000 0.5400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00090 SERINGA DESC 20 ML UN 0.0000 0.5387 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00090 SERINGA DESC 20 ML UN 0.0000 0.5387 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00090 SERINGA DESC 20 ML UN 0.0000 0.5387 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00090 SERINGA DESC 20 ML UN 0.0000 0.5387 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00090 SERINGA DESC 20 ML UN 0.0000 0.5387 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00090 SERINGA DESC 20 ML UN 0.0000 0.5387 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00090 SERINGA DESC 20 ML UN 0.0000 0.5387 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00090 SERINGA DESC 20 ML UN 0.0000 0.5387 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00090 SERINGA DESC 20 ML UN 0.0000 0.5400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00090 SERINGA DESC 20 ML UN 0.0000 0.5400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 00124 LUVA CIRURGICA UN 0.0000 1.4500 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 00124 LUVA CIRURGICA UN 0.0000 1.4473 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4074 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 01611 CLORETO DE POTASSIO 600 MG CA VO UN 0.0000 0.4867 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 01611 CLORETO DE POTASSIO 600 MG CA VO UN 0.0000 0.4867 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 01611 CLORETO DE POTASSIO 600 MG CA VO UN 0.0000 0.4867 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 01611 CLORETO DE POTASSIO 600 MG CA VO UN 0.0000 0.4867 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 01611 CLORETO DE POTASSIO 600 MG CA VO UN 0.0000 0.9733 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 25040014 Fisioterapia Respiratória - em Doente Clínico Internado 0.0000 5.0300 NULL EXAME NAO AUTORIZADO 2707
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 29020166 Nebulização Simples com Broncodilatador 0.0000 7.0200 NULL EXAME NAO AUTORIZADO 2707
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.8073 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1775 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1775 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1775 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1775 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1775 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1775 NULL VALOR APRESENTADO A MAIOR 1705
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1775 NULL VALOR APRESENTADO A MAIOR 1705
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 25040014 Fisioterapia Respiratória - em Doente Clínico Internado 0.0000 10.0600 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 25040014 Fisioterapia Respiratória - em Doente Clínico Internado 0.0000 10.0600 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 35382 COMPRESSAS DE GASES 7.5 X7,5 (11 FIOS ESTERIL) UN 0.0000 0.3000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 35382 COMPRESSAS DE GASES 7.5 X7,5 (11 FIOS ESTERIL) UN 0.0000 0.0000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 35382 COMPRESSAS DE GASES 7.5 X7,5 (11 FIOS ESTERIL) UN 0.0000 0.3000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 35382 COMPRESSAS DE GASES 7.5 X7,5 (11 FIOS ESTERIL) UN 0.0000 0.6000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 00090 SERINGA DESC 20 ML UN 0.0000 0.5367 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 00124 LUVA CIRURGICA UN 0.0000 1.4482 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 00124 LUVA CIRURGICA UN 0.0000 1.4500 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 00124 LUVA CIRURGICA UN 0.0000 1.4482 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 00124 LUVA CIRURGICA UN 0.0000 1.4500 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 00124 LUVA CIRURGICA UN 0.0000 1.4500 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 35382 COMPRESSAS DE GASES 7.5 X7,5 (11 FIOS ESTERIL) UN 0.0000 0.0600 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.4000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.4000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.4000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.4000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.4000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1752 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1752 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1748 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1752 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 51241 AGULHA 123X45 0.0000 0.1900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 51590 ABAIXADOR DE LINGUA UN 0.0000 0.0500 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 51590 ABAIXADOR DE LINGUA UN 0.0000 0.0500 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 51649 ALCOOL ETILICO 70 % ST TP ML 0.0000 0.0300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 51649 ALCOOL ETILICO 70 % ST TP ML 0.0000 0.0300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 52392 SONDA DE ASPIRAÇAO TRAQUEAL C/ VALVULA UN 0.0000 0.9352 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 52392 SONDA DE ASPIRAÇAO TRAQUEAL C/ VALVULA UN 0.0000 0.9400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 52392 SONDA DE ASPIRAÇAO TRAQUEAL C/ VALVULA UN 0.0000 0.9352 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 52392 SONDA DE ASPIRAÇAO TRAQUEAL C/ VALVULA UN 0.0000 0.9352 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6874 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6874 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6874 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6874 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6874 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 35382 COMPRESSAS DE GASES 7.5 X7,5 (11 FIOS ESTERIL) UN 0.0000 0.6000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.3500 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 51588 ESPARADRAPO MICROPORE 50 X 10 CM CM 0.0000 0.5100 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 53945 ACIDO ASCORBICO 500 MG CP VO UN 0.0000 0.5900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 01496 FENITOINA 50 MG/ML 5 ML SI IM IV AP 0.0000 2.3400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 01496 FENITOINA 50 MG/ML 5 ML SI IM IV AP 0.0000 2.3400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 01584 NEOSTIGMINA 0,5 MG/ML 1 ML SI IM IV SC AP 0.0000 0.7662 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 01584 NEOSTIGMINA 0,5 MG/ML 1 ML SI IM IV SC AP 0.0000 0.7662 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 01584 NEOSTIGMINA 0,5 MG/ML 1 ML SI IM IV SC AP 0.0000 0.7662 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00169 SORO GLICOSADO 5% 500 ML SI IV BS 0.0000 3.6715 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00171 SORO FISIOLOGICO 0,9% 250 ML SI IV BS 0.0000 3.9400 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 24082 BROMOPRIDA 5 MG/ML 2 ML SI IM IV AP 0.0000 2.7300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 24082 BROMOPRIDA 5 MG/ML 2 ML SI IM IV AP 0.0000 2.7300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 24082 BROMOPRIDA 5 MG/ML 2 ML SI IM IV AP 0.0000 2.7300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 24082 BROMOPRIDA 5 MG/ML 2 ML SI IM IV AP 0.0000 2.7300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 24082 BROMOPRIDA 5 MG/ML 2 ML SI IM IV AP 0.0000 2.7300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 26981 SORO FISIOLOGICO 0,9% 10 ML SI IV AP 0.0000 0.9600 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 26981 SORO FISIOLOGICO 0,9% 10 ML SI IV AP 0.0000 0.9600 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 26981 SORO FISIOLOGICO 0,9% 10 ML SI IV AP 0.0000 0.9600 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 26981 SORO FISIOLOGICO 0,9% 10 ML SI IV AP 0.0000 0.9600 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ea4ad2636c25d8e3dbb569ae62db71e7 IONE 12489788840 NULL 12489788840 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ea4ad2636c25d8e3dbb569ae62db71e7 IONE 12489788840 NULL 12489788840 00098 ABOCATH N 14 A 22 UN 0.0000 3.7700 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 d17b3c5ae418d82694895a326dee545a ODILIA 12670516743 NULL 12670516743 102001 DIARIA DE APARTAMENTO 0.0000 288.8882 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 d17b3c5ae418d82694895a326dee545a ODILIA 12670516743 NULL 12670516743 102001 DIARIA DE APARTAMENTO 0.0000 288.8882 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 d17b3c5ae418d82694895a326dee545a ODILIA 12670516743 NULL 12670516743 00128 LUVA DE PROCEDIMENTO UNIDADE UN 0.0000 1.0000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 d17b3c5ae418d82694895a326dee545a ODILIA 12670516743 NULL 12670516743 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL OPME INVALIDO 2201
Glosa Min 2018-10-03 00:00:00.000000 1084117 d17b3c5ae418d82694895a326dee545a ODILIA 12670516743 NULL 12670516743 02197 METAMUCIL (PLANTAGO OVATA) 3,4 G PO VO EV 0.0000 2.4600 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 d17b3c5ae418d82694895a326dee545a ODILIA 12670516743 NULL 12670516743 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 d17b3c5ae418d82694895a326dee545a ODILIA 12670516743 NULL 12670516743 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 d17b3c5ae418d82694895a326dee545a ODILIA 12670516743 NULL 12670516743 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 d17b3c5ae418d82694895a326dee545a ODILIA 12670516743 NULL 12670516743 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 102001 DIARIA DE APARTAMENTO 0.0000 288.8882 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 102001 DIARIA DE APARTAMENTO 0.0000 288.8882 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4074 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4074 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4074 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4074 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4074 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4072 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 02246 HIDROCORTISONA 100 MG PO IM IV FA 0.0000 2.8300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 02246 HIDROCORTISONA 100 MG PO IM IV FA 0.0000 2.8300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 26981 SORO FISIOLOGICO 0,9% 10 ML SI IV AP 0.0000 0.4800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 26981 SORO FISIOLOGICO 0,9% 10 ML SI IV AP 0.0000 0.4800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 00404 LACTULOSE 667 MG/ML XP VO ML 0.0000 0.2100 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 00404 LACTULOSE 667 MG/ML XP VO ML 0.0000 6.4300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 00404 LACTULOSE 667 MG/ML XP VO ML 0.0000 6.4300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 00487 RANITIDINA 25 MG/ML 2 ML SI IM IV AP 0.0000 0.9300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 00487 RANITIDINA 25 MG/ML 2 ML SI IM IV AP 0.0000 0.9300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1771 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1771 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1771 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 081fdadb830fb547e83c43fabdb88372 ELZA 12377335349 NULL 12377335349 51240 FITA ADVANTAGE P/ GLICOSE UN 0.0000 5.1800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 081fdadb830fb547e83c43fabdb88372 ELZA 12377335349 NULL 12377335349 09071 ACETILCISTEINA 600MG PO VO SA 0.0000 3.5000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 081fdadb830fb547e83c43fabdb88372 ELZA 12377335349 NULL 12377335349 09071 ACETILCISTEINA 600MG PO VO SA 0.0000 3.5000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 00172 SORO FISIOLOGICO 0,9% 500 ML SI IV BS 0.0000 9.4698 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 00172 SORO FISIOLOGICO 0,9% 500 ML SI IV BS 0.0000 9.4698 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 00172 SORO FISIOLOGICO 0,9% 500 ML SI IV BS 0.0000 9.4698 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 24571 CLINDAMICINA 600 MG 4 ML SI IM IV AP 0.0000 13.0800 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 24571 CLINDAMICINA 600 MG 4 ML SI IM IV AP 0.0000 13.0800 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 24571 CLINDAMICINA 600 MG 4 ML SI IM IV AP 0.0000 13.0800 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 24571 CLINDAMICINA 600 MG 4 ML SI IM IV AP 0.0000 13.0800 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 24571 CLINDAMICINA 600 MG 4 ML SI IM IV AP 0.0000 13.0800 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 24571 CLINDAMICINA 600 MG 4 ML SI IM IV AP 0.0000 13.0800 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 24571 CLINDAMICINA 600 MG 4 ML SI IM IV AP 0.0000 13.0800 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 24571 CLINDAMICINA 600 MG 4 ML SI IM IV AP 0.0000 13.0800 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR APRESENTADO A MAIOR 1705
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR APRESENTADO A MAIOR 1705
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 14191 OMEPRAZOL 20 MG CA VO UN 0.0000 0.9000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 00406 FUROSEMIDA 10 MG/ML 2 ML SI IM IV AP 0.0000 0.6000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 00406 FUROSEMIDA 10 MG/ML 2 ML SI IM IV AP 0.0000 0.6000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 00487 RANITIDINA 25 MG/ML 2 ML SI IM IV AP 0.0000 0.9300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.8100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.8100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 51241 AGULHA 123X45 0.0000 0.7700 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 51379 SERINGA DESC 05 ML UN 0.0000 0.1900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 51379 SERINGA DESC 05 ML UN 0.0000 0.1900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 51379 SERINGA DESC 05 ML UN 0.0000 0.1900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 51497 ESPIRONOLACTONA 50 MG + HIDROCLOROTIAZIDA 50 MG 0.0000 0.9800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 51497 ESPIRONOLACTONA 50 MG + HIDROCLOROTIAZIDA 50 MG 0.0000 0.9800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 51584 ESPARADRAPO MICROPORE 0.0000 0.2600 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 51584 ESPARADRAPO MICROPORE 0.0000 0.7700 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 51584 ESPARADRAPO MICROPORE 0.0000 0.7700 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 51588 ESPARADRAPO MICROPORE 50 X 10 CM CM 0.0000 0.7700 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 51589 ESPARADRAPO 10 X 4.5 CM CM 0.0000 0.4000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 00541 AMIODARONA 200 MG CP VO UN 0.0000 0.8400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 06400 CARVEDILOL 3,125 MG CP VO UN 0.0000 0.7300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 102001 DIARIA DE APARTAMENTO 0.0000 288.8900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 11325 EQUIPO MACRO-GOTAS FLEXIVEL C/ INJETOR LATERAL UN 0.0000 3.1800 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 51649 ALCOOL ETILICO 70 % ST TP ML 0.0000 0.0300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 51649 ALCOOL ETILICO 70 % ST TP ML 0.0000 0.0300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 51649 ALCOOL ETILICO 70 % ST TP ML 0.0000 0.0300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 51649 ALCOOL ETILICO 70 % ST TP ML 0.0000 0.0600 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 00090 SERINGA DESC 20 ML UN 0.0000 0.5400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 00090 SERINGA DESC 20 ML UN 0.0000 0.5400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 00090 SERINGA DESC 20 ML UN 0.0000 0.5400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 00090 SERINGA DESC 20 ML UN 0.0000 0.5400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 00919 ALGODAO HIDROFILO BOLINHA UN 0.0000 0.2600 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 00943 EQUIPO POLIFIX 2 VIAS UN 0.0000 2.5500 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 00943 EQUIPO POLIFIX 2 VIAS UN 0.0000 2.5500 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 f3ad474c8c562757c4d1a959ff0961c4 DJALMA 12718763240 NULL 12718763240 00124 LUVA CIRURGICA UN 0.0000 1.4500 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 f3ad474c8c562757c4d1a959ff0961c4 DJALMA 12718763240 NULL 12718763240 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 f3ad474c8c562757c4d1a959ff0961c4 DJALMA 12718763240 NULL 12718763240 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 f3ad474c8c562757c4d1a959ff0961c4 DJALMA 12718763240 NULL 12718763240 03280 CLOREXIDINA 2 % ST TP ML 0.0000 0.2700 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 f3ad474c8c562757c4d1a959ff0961c4 DJALMA 12718763240 NULL 12718763240 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 f3ad474c8c562757c4d1a959ff0961c4 DJALMA 12718763240 NULL 12718763240 00090 SERINGA DESC 20 ML UN 0.0000 0.5400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 f3ad474c8c562757c4d1a959ff0961c4 DJALMA 12718763240 NULL 12718763240 00090 SERINGA DESC 20 ML UN 0.0000 0.5400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 806bfa8e76209648a4ae145ff436d092 GILBERTO 12692620640 NULL 12692620640 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6875 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 806bfa8e76209648a4ae145ff436d092 GILBERTO 12692620640 NULL 12692620640 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6875 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 806bfa8e76209648a4ae145ff436d092 GILBERTO 12692620640 NULL 12692620640 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6875 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3fb5c891f31bb9efcb05395066127c52 ALAIDE 12636273441 NULL 12636273441 14250 PARACETAMOL 750 MG CP VO UN 0.0000 0.0000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00090 SERINGA DESC 20 ML UN 0.5400 0.2200 0.3200 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00090 SERINGA DESC 20 ML UN 0.5400 0.2200 0.3200 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00090 SERINGA DESC 20 ML UN 0.5400 0.2200 0.3200 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00090 SERINGA DESC 20 ML UN 0.5400 0.2200 0.3200 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.6900 0.2700 0.4200 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.6900 0.2700 0.4200 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.6900 0.2700 0.4200 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.6900 0.2700 0.4200 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.6900 0.2700 0.4200 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00128 LUVA DE PROCEDIMENTO UNIDADE UN 1.0000 0.3900 0.6100 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 56456 ZOLPIDEM 10 MG CP VO UN 1.2800 0.4900 0.7900 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00493 BROMOPRIDA 5 MG/ML 2 ML SI IM IV AP 2.7300 1.0600 1.6700 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00124 LUVA CIRURGICA UN 2.9000 1.1300 1.7700 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 51163 AGUA BIDESTILADA 250 ML 5.7900 2.2600 3.5300 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 52959 FIO MONONYLON 2-0 C/AGULHA 3,0 3/8 1215T EV 6.1700 2.4000 3.7700 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00404 LACTULOSE 667 MG/ML XP VO ML 6.4300 2.5100 3.9200 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00613 CLINDAMICINA 600 MG 4 ML SI IM IV AP 13.0800 5.1000 7.9800 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 16b1e9f62f247f02ad5cac910ee15b4e BERCHOLINA 12631612848 NULL 12631612848 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4081 0.0019 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 16b1e9f62f247f02ad5cac910ee15b4e BERCHOLINA 12631612848 NULL 12631612848 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4081 0.0019 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 16b1e9f62f247f02ad5cac910ee15b4e BERCHOLINA 12631612848 NULL 12631612848 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4081 0.0019 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 16b1e9f62f247f02ad5cac910ee15b4e BERCHOLINA 12631612848 NULL 12631612848 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4081 0.0019 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 16b1e9f62f247f02ad5cac910ee15b4e BERCHOLINA 12631612848 NULL 12631612848 19160 SERINGA DESC 20 ML UN 0.5400 0.5386 0.0014 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 16b1e9f62f247f02ad5cac910ee15b4e BERCHOLINA 12631612848 NULL 12631612848 33219 LUVA DE PROCEDIMENTO UNIDADE UN 0.8370 1.0018 -0.3318 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 16b1e9f62f247f02ad5cac910ee15b4e BERCHOLINA 12631612848 NULL 12631612848 00090 SERINGA DESC 20 ML UN 0.5400 0.5200 0.0200 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 16b1e9f62f247f02ad5cac910ee15b4e BERCHOLINA 12631612848 NULL 12631612848 00090 SERINGA DESC 20 ML UN 0.5400 0.5200 0.0200 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 16b1e9f62f247f02ad5cac910ee15b4e BERCHOLINA 12631612848 NULL 12631612848 00171 SORO FISIOLOGICO 0,9% 250 ML SI IV BS 3.9400 3.7600 0.1800 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 01081195 b477554b2b27a1385e29647b9a3a0084 MARIA 12811135119 NULL 12811135119 00010014 CONSULTA EM CONSULTORIO MEDICO 0.0000 0.0000 50.0000 GUIA DE CONSULTA NAO EXECUTADA 0622
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 37761 ALCOOL ETILICO 70 % ST TP ML 0.0300 0.0200 0.0100 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 08648 ESPARADRAPO 10 X 4.5 CM CM 0.4000 0.2000 0.2000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 53660 EQUIPO MACRO-GOTAS FLEXIVEL C/ INJETOR LATE 1.5900 0.0000 1.5900 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 37761 ALCOOL ETILICO 70 % ST TP ML 0.0600 0.0200 0.0400 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 08648 ESPARADRAPO 10 X 4.5 CM CM 0.4000 0.2000 0.2000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 00817 ALGODAO HIDROFILO BOLINHA UN 0.5100 0.1300 0.3800 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 37761 ALCOOL ETILICO 70 % ST TP ML 0.0600 0.0300 0.0300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 00817 ALGODAO HIDROFILO BOLINHA UN 0.0500 0.0000 0.0500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 00817 ALGODAO HIDROFILO BOLINHA UN 0.5100 0.2600 0.2500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 52302 CLOREXIDINA SL TP BU ML 0.4200 0.0600 0.3600 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 37761 ALCOOL ETILICO 70 % ST TP ML 0.0600 0.0200 0.0400 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 75bcd473a0dc7c7a6751499b38a4a034 JOAQUIM 12692852143 NULL 12692852143 08664 ESPARADRAPO MICROPORE 50 X 10 CM CM 0.7700 0.0000 0.7700 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 75bcd473a0dc7c7a6751499b38a4a034 JOAQUIM 12692852143 NULL 12692852143 08648 ESPARADRAPO 10 X 4.5 CM CM 0.4000 0.1000 0.3000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 75bcd473a0dc7c7a6751499b38a4a034 JOAQUIM 12692852143 NULL 12692852143 08648 ESPARADRAPO 10 X 4.5 CM CM 0.4000 0.1000 0.3000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 4668d2494ed6c4b2d18be299efcb26a2 JOAO 12469689344 NULL 12469689344 11193 CLOREXIDINA 2 % ST TP ML 2.6600 1.8600 0.8000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 4668d2494ed6c4b2d18be299efcb26a2 JOAO 12469689344 NULL 12469689344 08648 ESPARADRAPO 10 X 4.5 CM CM 0.4000 0.2600 0.1400 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 4668d2494ed6c4b2d18be299efcb26a2 JOAO 12469689344 NULL 12469689344 08664 ESPARADRAPO MICROPORE 50 X 10 CM CM 0.7700 0.2600 0.5100 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 00817 ALGODAO HIDROFILO BOLINHA UN 0.5100 0.2600 0.2500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 37761 ALCOOL ETILICO 70 % ST TP ML 0.0300 0.0200 0.0100 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 52582 CATETER OXIGENIO TIPO OCULOS UN 1.0000 0.0000 1.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 02461 FENOTEROL 2 MG/ML 10 ML AE IN DS 0.3400 0.0000 0.3400 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 30376 BROMETO DE IPRATROPIO 0,25MG/ML SL IN GT 0.6000 0.0000 0.6000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 33219 LUVA DE PROCEDIMENTO UNIDADE UN 0.6700 0.0000 0.6700 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 37761 ALCOOL ETILICO 70 % ST TP ML 0.0300 0.0200 0.0100 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 37761 ALCOOL ETILICO 70 % ST TP ML 0.0300 0.0200 0.0100 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 37761 ALCOOL ETILICO 70 % ST TP ML 0.0300 0.0200 0.0100 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 00817 ALGODAO HIDROFILO BOLINHA UN 0.2600 0.1300 0.1300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00035 ABOCATH (CATETER INTRAVENOSO) N. 14 A 22 UN 11.3000 3.7700 7.5300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 33219 LUVA DE PROCEDIMENTO UNIDADE UN 1.0000 0.6700 0.3300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 37761 ALCOOL ETILICO 70 % ST TP ML 0.0300 0.0200 0.0100 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 33219 LUVA DE PROCEDIMENTO UNIDADE UN 1.0000 0.6700 0.3300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 37761 ALCOOL ETILICO 70 % ST TP ML 0.0300 0.0200 0.0100 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 11193 CLOREXIDINA 2 % ST TP ML 0.8000 0.0000 0.8000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 08664 ESPARADRAPO MICROPORE 50 X 10 CM CM 0.7700 0.0000 0.7700 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 37761 ALCOOL ETILICO 70 % ST TP ML 0.0300 0.0200 0.0100 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 52582 CATETER OXIGENIO TIPO OCULOS UN 1.0000 0.0000 1.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 11193 CLOREXIDINA 2 % ST TP ML 0.8000 0.0000 0.8000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 22748 LIDOCAINA 2% GE TP OU GR 2.5900 1.3000 1.2900 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 33219 LUVA DE PROCEDIMENTO UNIDADE UN 1.0000 0.6700 0.3300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 05975 COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER 0.9000 0.0000 0.9000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12558131243 NULL 12558131243 08664 ESPARADRAPO MICROPORE 50 X 10 CM CM 0.7700 0.2600 0.5100 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00817 ALGODAO HIDROFILO BOLINHA UN 0.2600 0.1300 0.1300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 37761 ALCOOL ETILICO 70 % ST TP ML 0.0300 0.0200 0.0100 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00817 ALGODAO HIDROFILO BOLINHA UN 0.2600 0.1300 0.1300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 7c2bc8cd9bbf9ce081562a3c63fff8c9 MARTA 12647505849 NULL 12647505849 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4000 0.0000 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 7c2bc8cd9bbf9ce081562a3c63fff8c9 MARTA 12647505849 NULL 12647505849 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1752 0.0048 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 7c2bc8cd9bbf9ce081562a3c63fff8c9 MARTA 12647505849 NULL 12647505849 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1756 0.0044 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 f65f553befc0e3bc8bd5bce5c1c6e413 NAIRLENE 12633078944 NULL 12633078944 19160 SERINGA DESC 20 ML UN 0.5400 0.5367 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 f65f553befc0e3bc8bd5bce5c1c6e413 NAIRLENE 12633078944 NULL 12633078944 19160 SERINGA DESC 20 ML UN 0.5400 0.5367 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 f65f553befc0e3bc8bd5bce5c1c6e413 NAIRLENE 12633078944 NULL 12633078944 19160 SERINGA DESC 20 ML UN 0.5400 0.5367 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 f65f553befc0e3bc8bd5bce5c1c6e413 NAIRLENE 12633078944 NULL 12633078944 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4067 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 f65f553befc0e3bc8bd5bce5c1c6e413 NAIRLENE 12633078944 NULL 12633078944 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4067 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 f65f553befc0e3bc8bd5bce5c1c6e413 NAIRLENE 12633078944 NULL 12633078944 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4067 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 f65f553befc0e3bc8bd5bce5c1c6e413 NAIRLENE 12633078944 NULL 12633078944 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4067 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 f65f553befc0e3bc8bd5bce5c1c6e413 NAIRLENE 12633078944 NULL 12633078944 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1760 0.0040 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 f65f553befc0e3bc8bd5bce5c1c6e413 NAIRLENE 12633078944 NULL 12633078944 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1760 0.0040 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 f65f553befc0e3bc8bd5bce5c1c6e413 NAIRLENE 12633078944 NULL 12633078944 07269 DIPIRONA 500 MG/ML 2 ML SI IV IM AP 0.6900 0.6867 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 c2bcdc3cbedb73a0db271ac09d4587a1 ORDETE 12694018147 NULL 12694018147 20567 SORO FISIOLOGICO 0,9% 500 ML SI IV BS 9.4700 9.4680 0.0020 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 026c6dcfddc3d74250c79f449289696a SALOMAO 12456038443 NULL 12456038443 33219 LUVA DE PROCEDIMENTO UNIDADE UN 1.0000 0.9900 0.0000 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 026c6dcfddc3d74250c79f449289696a SALOMAO 12456038443 NULL 12456038443 07269 DIPIRONA 500 MG/ML 2 ML SI IV IM AP 0.6900 0.6800 0.0000 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 026c6dcfddc3d74250c79f449289696a SALOMAO 12456038443 NULL 12456038443 12262 ISOSSORBIDA 20 MG CP VO UN 0.2200 0.2150 0.0050 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 d4089ccef13567fd45b16fb0b60685fa VERA 12640482546 NULL 12640482546 33219 LUVA DE PROCEDIMENTO UNIDADE UN 1.0000 0.9900 0.0000 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 d4089ccef13567fd45b16fb0b60685fa VERA 12640482546 NULL 12640482546 27480 CLARITROMICINA 500 MG 30 ML PO IV FA 117.1100 117.1050 0.0050 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 d4089ccef13567fd45b16fb0b60685fa VERA 12640482546 NULL 12640482546 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1748 0.0052 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 d4089ccef13567fd45b16fb0b60685fa VERA 12640482546 NULL 12640482546 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1754 0.0046 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 d4089ccef13567fd45b16fb0b60685fa VERA 12640482546 NULL 12640482546 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1754 0.0046 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 d4089ccef13567fd45b16fb0b60685fa VERA 12640482546 NULL 12640482546 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1754 0.0046 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 d4089ccef13567fd45b16fb0b60685fa VERA 12640482546 NULL 12640482546 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1754 0.0046 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 d4089ccef13567fd45b16fb0b60685fa VERA 12640482546 NULL 12640482546 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1754 0.0046 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 d4089ccef13567fd45b16fb0b60685fa VERA 12640482546 NULL 12640482546 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1754 0.0046 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 d4089ccef13567fd45b16fb0b60685fa VERA 12640482546 NULL 12640482546 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1754 0.0046 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 d4089ccef13567fd45b16fb0b60685fa VERA 12640482546 NULL 12640482546 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1754 0.0046 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4074 0.0026 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4074 0.0026 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 19160 SERINGA DESC 20 ML UN 0.5400 0.5372 0.0028 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 19160 SERINGA DESC 20 ML UN 0.5400 0.5372 0.0028 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 19160 SERINGA DESC 20 ML UN 0.5400 0.5372 0.0028 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 19160 SERINGA DESC 20 ML UN 0.5400 0.5372 0.0028 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 19160 SERINGA DESC 20 ML UN 0.5400 0.5372 0.0028 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 19160 SERINGA DESC 20 ML UN 0.5400 0.5372 0.0028 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1d6bbb4a00130e2e654e830fc9bae6a ALEXANDRINA 12694224940 NULL 12694224940 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4072 0.0028 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1d6bbb4a00130e2e654e830fc9bae6a ALEXANDRINA 12694224940 NULL 12694224940 19160 SERINGA DESC 20 ML UN 0.5400 0.5367 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1d6bbb4a00130e2e654e830fc9bae6a ALEXANDRINA 12694224940 NULL 12694224940 19160 SERINGA DESC 20 ML UN 0.5400 0.5367 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1d6bbb4a00130e2e654e830fc9bae6a ALEXANDRINA 12694224940 NULL 12694224940 19160 SERINGA DESC 20 ML UN 0.5400 0.5367 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1d6bbb4a00130e2e654e830fc9bae6a ALEXANDRINA 12694224940 NULL 12694224940 19160 SERINGA DESC 20 ML UN 0.5400 0.5367 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1d6bbb4a00130e2e654e830fc9bae6a ALEXANDRINA 12694224940 NULL 12694224940 19160 SERINGA DESC 20 ML UN 0.5400 0.5367 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 345c226bfea274af1372d41b0305a6c8 ALTINO 12720257940 NULL 12720257940 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1000 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 345c226bfea274af1372d41b0305a6c8 ALTINO 12720257940 NULL 12720257940 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1000 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 345c226bfea274af1372d41b0305a6c8 ALTINO 12720257940 NULL 12720257940 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1000 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1038 -0.0038 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1038 -0.0038 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1038 -0.0038 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1038 -0.0038 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 19160 SERINGA DESC 20 ML UN 0.5400 0.5378 0.0022 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1787 0.0013 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1797 0.0003 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1900 0.1797 0.0103 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 17906 PROTAMINA 1000 UI/ML 5 ML SI IV AP 16.3400 13.6200 2.7200 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 05975 COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER 0.6000 0.0000 0.6000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 05975 COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER 0.3000 0.0000 0.3000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 05975 COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER 0.6000 0.0000 0.6000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 05975 COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER 0.6000 0.1500 0.4500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 05975 COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER 0.3000 0.0000 0.3000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 b288bbcfb9aecab51bcb0dba62ca0059 IVONETE 12743730847 NULL 12743730847 20672 SORO RINGER SIMPLES 500 ML SI IV BS 5.9400 5.9300 0.0000 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 670141098c0309ac9be3db204bdc12cf LEOSINA 12706525442 NULL 12706525442 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1767 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 27480 CLARITROMICINA 500 MG 30 ML PO IV FA 117.1100 117.1050 0.0050 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1758 0.0042 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1758 0.0042 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1758 0.0042 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1758 0.0042 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1758 0.0042 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4084 0.0016 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4084 0.0016 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4084 0.0016 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4084 0.0016 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4084 0.0016 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4084 0.0016 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 19160 SERINGA DESC 20 ML UN 0.5400 0.5384 0.0016 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 19160 SERINGA DESC 20 ML UN 0.5400 0.5384 0.0016 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 19160 SERINGA DESC 20 ML UN 0.5400 0.5384 0.0016 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 19160 SERINGA DESC 20 ML UN 0.5400 0.5384 0.0016 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 19160 SERINGA DESC 20 ML UN 0.5400 0.5384 0.0016 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 19160 SERINGA DESC 20 ML UN 0.5400 0.5384 0.0016 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 32204 CLORETO DE SODIO 0,9% 10 ML SI IV AP 0.9600 0.4800 0.4800 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 02461 FENOTEROL 2 MG/ML 10 ML AE IN DS 0.4300 0.4300 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 19445 CLORETO DE POTASSIO 600 MG CA VO UN 0.4900 0.4867 0.0033 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4075 0.0025 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4075 0.0025 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 07269 DIPIRONA 500 MG/ML 2 ML SI IV IM AP 0.6900 0.6865 0.0035 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 07269 DIPIRONA 500 MG/ML 2 ML SI IV IM AP 0.6900 0.6865 0.0035 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 07269 DIPIRONA 500 MG/ML 2 ML SI IV IM AP 0.6900 0.6865 0.0035 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 07269 DIPIRONA 500 MG/ML 2 ML SI IV IM AP 0.6900 0.6865 0.0035 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 07269 DIPIRONA 500 MG/ML 2 ML SI IV IM AP 0.6900 0.6865 0.0035 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1769 0.0031 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1769 0.0031 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1769 0.0031 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1769 0.0031 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1769 0.0031 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1769 0.0031 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1769 0.0031 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8073 0.0027 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8073 0.0027 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 33227 LUVA CIRURGICA PAR UN 1.4500 1.4477 0.0023 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 19160 SERINGA DESC 20 ML UN 0.5400 0.5372 0.0028 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 19160 SERINGA DESC 20 ML UN 1.0800 1.0744 0.0056 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1779 0.0021 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1779 0.0021 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1779 0.0021 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1779 0.0021 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1779 0.0021 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1779 0.0021 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8092 0.0008 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 08664 ESPARADRAPO MICROPORE 50 X 10 CM CM 0.2600 0.2558 0.0042 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 08664 ESPARADRAPO MICROPORE 50 X 10 CM CM 0.2600 0.2558 0.0042 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 08664 ESPARADRAPO MICROPORE 50 X 10 CM CM 0.2600 0.2558 0.0042 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e2b254ce765be196b019032789d8f852 MARIA 12576216044 NULL 12576216044 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4078 0.0022 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 08664 ESPARADRAPO MICROPORE 50 X 10 CM CM 0.7700 0.2550 0.5150 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 19135 SERINGA DESC 03 ML UN 0.1500 0.0000 0.1500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 19135 SERINGA DESC 03 ML UN 0.1500 0.1500 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 19135 SERINGA DESC 03 ML UN 0.3000 0.0000 0.3000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 37761 ALCOOL ETILICO 70 % ST TP ML 0.0300 0.0000 0.0300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 37761 ALCOOL ETILICO 70 % ST TP ML 0.0300 0.0200 0.0100 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 d17b3c5ae418d82694895a326dee545a ODILIA 12670516743 NULL 12670516743 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1774 0.0026 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 d17b3c5ae418d82694895a326dee545a ODILIA 12670516743 NULL 12670516743 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1774 0.0026 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 d17b3c5ae418d82694895a326dee545a ODILIA 12670516743 NULL 12670516743 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1774 0.0026 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 d17b3c5ae418d82694895a326dee545a ODILIA 12670516743 NULL 12670516743 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1774 0.0026 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 6ccea6ac8c216c032723aee73a9f81c9 PRISCILA 12662249242 NULL 12662249242 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4067 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 6ccea6ac8c216c032723aee73a9f81c9 PRISCILA 12662249242 NULL 12662249242 20672 SORO RINGER SIMPLES 500 ML SI IV BS 5.9400 5.9375 0.0025 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 6ccea6ac8c216c032723aee73a9f81c9 PRISCILA 12662249242 NULL 12662249242 20672 SORO RINGER SIMPLES 500 ML SI IV BS 11.8800 11.8750 0.0050 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 6ccea6ac8c216c032723aee73a9f81c9 PRISCILA 12662249242 NULL 12662249242 19160 SERINGA DESC 20 ML UN 0.5400 0.5373 0.0027 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1000 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1000 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1000 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1000 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1000 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1000 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1000 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1000 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1000 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1000 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1000 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1000 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1000 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1000 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1000 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1766 0.0034 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 33227 LUVA CIRURGICA PAR UN 1.4500 1.4476 0.0024 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 33227 LUVA CIRURGICA PAR UN 1.4500 1.4476 0.0024 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 19160 SERINGA DESC 20 ML UN 0.5400 0.5380 0.0020 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 19160 SERINGA DESC 20 ML UN 0.5400 0.5384 0.0016 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 19160 SERINGA DESC 20 ML UN 0.5400 0.5384 0.0016 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 19160 SERINGA DESC 20 ML UN 0.5400 0.5384 0.0016 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 19160 SERINGA DESC 20 ML UN 0.5400 0.5384 0.0016 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 19160 SERINGA DESC 20 ML UN 0.5400 0.5384 0.0016 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 19160 SERINGA DESC 20 ML UN 0.5400 0.5384 0.0016 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 32891 EQUIPO POLIFIX 2ş VIAS UN 2.5500 2.5500 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1776 0.0024 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1776 0.0024 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8092 0.0008 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 11193 CLOREXIDINA 2 % ST TP ML 0.5300 0.5300 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 08435 EQUIPO P/ BOMBA DE INFUSAO ENTERAL / PARENT 20.2800 20.2800 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 08435 EQUIPO P/ BOMBA DE INFUSAO ENTERAL / PARENT 20.2800 20.2800 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 6799aa3de305405ab065aad5b599765c VANIR 12700232345 NULL 12700232345 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1750 0.0050 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 6799aa3de305405ab065aad5b599765c VANIR 12700232345 NULL 12700232345 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1750 0.0050 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 6799aa3de305405ab065aad5b599765c VANIR 12700232345 NULL 12700232345 07269 DIPIRONA 500 MG/ML 2 ML SI IV IM AP 0.6900 0.6870 0.0030 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 0111beed375944f60c7ad4a7fd4874f8 WALDIR 12746025744 NULL 12746025744 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1778 0.0022 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 0111beed375944f60c7ad4a7fd4874f8 WALDIR 12746025744 NULL 12746025744 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1773 0.0027 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 0111beed375944f60c7ad4a7fd4874f8 WALDIR 12746025744 NULL 12746025744 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1773 0.0027 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 0111beed375944f60c7ad4a7fd4874f8 WALDIR 12746025744 NULL 12746025744 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8074 0.0026 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 05975 COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER 0.3000 0.0000 0.3000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 29661 NOREPINEFRINA 2 MG/ML 4 ML SI IV AP 142.4500 142.4438 0.0063 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8079 0.0021 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8079 0.0021 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8079 0.0021 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8079 0.0021 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8079 0.0021 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 08435 EQUIPO P/ BOMBA DE INFUSAO ENTERAL / PARENT 20.2800 20.2775 0.0025 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 75bcd473a0dc7c7a6751499b38a4a034 JOAQUIM 12692852143 NULL 12692852143 00817 ALGODAO HIDROFILO BOLINHA UN 0.2600 0.1300 0.1300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 610c198ec4c064687cf0524f147d3aed ROBERTO 12748814743 NULL 12748814743 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1780 0.0020 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 610c198ec4c064687cf0524f147d3aed ROBERTO 12748814743 NULL 12748814743 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1767 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 610c198ec4c064687cf0524f147d3aed ROBERTO 12748814743 NULL 12748814743 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1767 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 610c198ec4c064687cf0524f147d3aed ROBERTO 12748814743 NULL 12748814743 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1767 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 610c198ec4c064687cf0524f147d3aed ROBERTO 12748814743 NULL 12748814743 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4083 0.0017 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12647284040 NULL 12647284040 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1750 0.0050 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12647284040 NULL 12647284040 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1750 0.0050 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12647284040 NULL 12647284040 08664 ESPARADRAPO MICROPORE 50 X 10 CM CM 0.7700 0.7664 0.0036 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12647284040 NULL 12647284040 08664 ESPARADRAPO MICROPORE 50 X 10 CM CM 0.7700 0.7667 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12647284040 NULL 12647284040 20567 SORO FISIOLOGICO 0,9% 500 ML SI IV BS 9.4700 9.4697 0.0003 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12647284040 NULL 12647284040 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4086 0.0014 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12647284040 NULL 12647284040 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4086 0.0014 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00817 ALGODAO HIDROFILO BOLINHA UN 0.2600 0.1300 0.1300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 08664 ESPARADRAPO MICROPORE 50 X 10 CM CM 0.2600 0.0000 0.2600 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 08664 ESPARADRAPO MICROPORE 50 X 10 CM CM 0.2600 0.0000 0.2600 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 33588 CLORETO DE SODIO 20% 10 ML SI IV AP 1.1000 1.1250 -0.0250 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 33545 PIPERACILINA 4 G + TAZOBACTAM 500 MG PO IV 83.4500 83.4500 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 33545 PIPERACILINA 4 G + TAZOBACTAM 500 MG PO IV 83.4500 83.4500 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 33545 PIPERACILINA 4 G + TAZOBACTAM 500 MG PO IV 83.4500 83.4500 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 33545 PIPERACILINA 4 G + TAZOBACTAM 500 MG PO IV 83.4500 83.4500 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 33545 PIPERACILINA 4 G + TAZOBACTAM 500 MG PO IV 83.4500 83.4500 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 6.8145 -3.4045 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 6.8145 -3.4045 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 6.8145 -3.4045 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 6.8145 -3.4045 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4072 0.0028 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4072 0.0028 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4072 0.0028 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4072 0.0028 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4072 0.0028 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 33227 LUVA CIRURGICA PAR UN 2.9000 2.9000 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.2120 -0.1120 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.2120 -0.1120 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 19160 SERINGA DESC 20 ML UN 0.5400 0.5374 0.0026 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 19160 SERINGA DESC 20 ML UN 0.5400 0.5374 0.0026 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 19160 SERINGA DESC 20 ML UN 0.5400 0.5374 0.0026 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 19160 SERINGA DESC 20 ML UN 0.5400 0.5374 0.0026 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 19160 SERINGA DESC 20 ML UN 0.5400 0.5374 0.0026 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 19160 SERINGA DESC 20 ML UN 0.5400 0.5374 0.0026 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1786 0.0014 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.4000 0.4037 -0.0037 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.4000 0.4037 -0.0037 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.4000 0.4037 -0.0037 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.4000 0.4037 -0.0037 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.4000 0.4037 -0.0037 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8073 0.0027 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8073 0.0027 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8073 0.0027 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8073 0.0027 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 13757 IODOPOVIDONA SD TP ML 0.4000 0.4000 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 13757 IODOPOVIDONA SD TP ML 0.4000 0.4000 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 09636 FLORATIL (SACCHAROMYCES BOULARDII) 200 MG P 4.4400 8.8851 -4.4451 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 09636 FLORATIL (SACCHAROMYCES BOULARDII) 200 MG P 4.4400 8.8851 -4.4451 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 19445 CLORETO DE POTASSIO 600 MG CA VO UN 1.4637 1.9474 -1.4574 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 05975 COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER 1.3439 1.3948 -0.7948 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 28959 DERSANI LC TP ML 12.6100 13.5800 -3.8800 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 55018 ALGINATO DE CALCIO EM HIDROGEL GL TP GR 3.4500 3.4500 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 08664 ESPARADRAPO MICROPORE 50 X 10 CM CM 1.3564 1.3849 -0.8749 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 08664 ESPARADRAPO MICROPORE 50 X 10 CM CM 1.3564 1.3849 -0.8749 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 08664 ESPARADRAPO MICROPORE 50 X 10 CM CM 1.3564 1.3849 -0.8749 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1d6bbb4a00130e2e654e830fc9bae6a ALEXANDRINA 12694224940 NULL 12694224940 05274 AMOXICILINA 500 MG + CLAVULANATO 125 MG CP 3.1700 3.1667 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 03280 CLOREXIDINA 2 % ST TP ML NULL 0.0000 NULL OPME INVALIDO 2201
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 03280 CLOREXIDINA 2 % ST TP ML NULL 0.0000 NULL OPME INVALIDO 2201
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 03280 CLOREXIDINA 2 % ST TP ML NULL 0.0000 NULL OPME INVALIDO 2201
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 51584 ESPARADRAPO MICROPORE NULL 0.0000 NULL OPME INVALIDO 2201
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 51584 ESPARADRAPO MICROPORE NULL 0.0000 NULL OPME INVALIDO 2201
Glosa Min 2018-10-03 00:00:00.000000 1084117 800720d33fe0defb6121e82dd216d044 JALMO 12786952647 NULL 12786952647 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 800720d33fe0defb6121e82dd216d044 JALMO 12786952647 NULL 12786952647 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 800720d33fe0defb6121e82dd216d044 JALMO 12786952647 NULL 12786952647 53973 Kit Protese Hibrida De Quadril Primaria 0.0000 0.2400 NULL OPME PAGO A FORNECEDOR TERCEIRIZADO 2213
Glosa Min 2018-10-03 00:00:00.000000 1084117 800720d33fe0defb6121e82dd216d044 JALMO 12786952647 NULL 12786952647 00757 CEFUROXIMA 750 MG + DIL. 6 ML PO IM IV FA 0.0000 26.1300 NULL VALOR APRESENTADO A MAIOR 1705
Glosa Min 2018-10-03 00:00:00.000000 1084117 800720d33fe0defb6121e82dd216d044 JALMO 12786952647 NULL 12786952647 00090 SERINGA DESC 20 ML UN 0.0000 0.5400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 800720d33fe0defb6121e82dd216d044 JALMO 12786952647 NULL 12786952647 00090 SERINGA DESC 20 ML UN 0.0000 0.5400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 752c651cb4fd049e19c685f87fbe8bdc EDUARDO 12765990646 NULL 12765990646 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6875 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 752c651cb4fd049e19c685f87fbe8bdc EDUARDO 12765990646 NULL 12765990646 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6875 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 752c651cb4fd049e19c685f87fbe8bdc EDUARDO 12765990646 NULL 12765990646 51163 AGUA BIDESTILADA 250 ML 0.0000 3.3900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 752c651cb4fd049e19c685f87fbe8bdc EDUARDO 12765990646 NULL 12765990646 51241 AGULHA 123X45 0.0000 0.1900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 752c651cb4fd049e19c685f87fbe8bdc EDUARDO 12765990646 NULL 12765990646 51671 REPARIL (ESCINA + DIETILAMONIO) GL TP GR 0.0000 0.7400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12558131243 NULL 12558131243 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1757 NULL VALOR APRESENTADO A MAIOR 1705
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12558131243 NULL 12558131243 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1757 NULL VALOR APRESENTADO A MAIOR 1705
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12558131243 NULL 12558131243 52010511 Fratura do Cóccix - Tratamento Cruento 0.0000 0.0000 NULL COBRANCA DE HONORARIOS EM DUPLICIDADE 2607
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12558131243 NULL 12558131243 52250091 Retirada de Enxerto Ósseo 0.0000 0.0000 NULL COBRANCA DE HONORARIOS EM DUPLICIDADE 2607
Glosa Min 2018-10-03 00:00:00.000000 1084117 526685c1041cc1316e874a2e95e67e2e JOSE 12696604949 NULL 12696604949 51649 ALCOOL ETILICO 70 % ST TP ML 0.0000 0.1800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 526685c1041cc1316e874a2e95e67e2e JOSE 12696604949 NULL 12696604949 00090 SERINGA DESC 20 ML UN 0.0000 0.5367 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 526685c1041cc1316e874a2e95e67e2e JOSE 12696604949 NULL 12696604949 00090 SERINGA DESC 20 ML UN 0.0000 0.5400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 526685c1041cc1316e874a2e95e67e2e JOSE 12696604949 NULL 12696604949 00090 SERINGA DESC 20 ML UN 0.0000 0.5367 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 11700 EQUIPO P/ BOMBA DE INFUSAO ENTERAL / PARENTERAL 0.0000 20.2800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00404 LACTULOSE 667 MG/ML XP VO ML 0.0000 4.2900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.0000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.4000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.4000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.4000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 51163 AGUA BIDESTILADA 250 ML 0.0000 5.7900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 51163 AGUA BIDESTILADA 250 ML 0.0000 5.7900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 51164 AGUA BIDESTILADA 500 ML 0.0000 6.4300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.0000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 51379 SERINGA DESC 05 ML UN 0.0000 0.1900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 51434 BECLOMETASONA 400 MCG / ML 2 ML SL IN FL 0.0000 4.4800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 51434 BECLOMETASONA 400 MCG / ML 2 ML SL IN FL 0.0000 4.4800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00613 CLINDAMICINA 600 MG 4 ML SI IM IV AP 0.0000 13.0800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00091 SERINGA DESC 01 ML (INSULINA) UN 0.0000 0.3057 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 0.0000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 4e13adf421809cb755e1bdd80cc4efed AGRIPINA 12385409142 NULL 12385409142 102001 DIARIA DE APARTAMENTO 0.0000 288.8800 NULL VALOR APRESENTADO A MAIOR 1705
Glosa Min 2018-10-03 00:00:00.000000 1084117 4e13adf421809cb755e1bdd80cc4efed AGRIPINA 12385409142 NULL 12385409142 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 4e13adf421809cb755e1bdd80cc4efed AGRIPINA 12385409142 NULL 12385409142 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 4e13adf421809cb755e1bdd80cc4efed AGRIPINA 12385409142 NULL 12385409142 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 1.3700 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 4e13adf421809cb755e1bdd80cc4efed AGRIPINA 12385409142 NULL 12385409142 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.4000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 4e13adf421809cb755e1bdd80cc4efed AGRIPINA 12385409142 NULL 12385409142 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.4000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 75bcd473a0dc7c7a6751499b38a4a034 JOAQUIM 12692852143 NULL 12692852143 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4075 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 75bcd473a0dc7c7a6751499b38a4a034 JOAQUIM 12692852143 NULL 12692852143 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4075 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 75bcd473a0dc7c7a6751499b38a4a034 JOAQUIM 12692852143 NULL 12692852143 01652 TRAMADOL 50 MG CP VO UN 0.0000 1.9272 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 75bcd473a0dc7c7a6751499b38a4a034 JOAQUIM 12692852143 NULL 12692852143 01652 TRAMADOL 50 MG CP VO UN 0.0000 1.9272 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 75bcd473a0dc7c7a6751499b38a4a034 JOAQUIM 12692852143 NULL 12692852143 01652 TRAMADOL 50 MG CP VO UN 0.0000 1.9272 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 75bcd473a0dc7c7a6751499b38a4a034 JOAQUIM 12692852143 NULL 12692852143 01652 TRAMADOL 50 MG CP VO UN 0.0000 1.9272 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 75bcd473a0dc7c7a6751499b38a4a034 JOAQUIM 12692852143 NULL 12692852143 00172 SORO FISIOLOGICO 0,9% 500 ML SI IV BS 0.0000 4.7300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 75bcd473a0dc7c7a6751499b38a4a034 JOAQUIM 12692852143 NULL 12692852143 00172 SORO FISIOLOGICO 0,9% 500 ML SI IV BS 0.0000 3.2400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 75bcd473a0dc7c7a6751499b38a4a034 JOAQUIM 12692852143 NULL 12692852143 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6850 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 75bcd473a0dc7c7a6751499b38a4a034 JOAQUIM 12692852143 NULL 12692852143 04073 TRAMADOL 50 MG 1 ML SI IM IV AP 0.0000 4.1900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 75bcd473a0dc7c7a6751499b38a4a034 JOAQUIM 12692852143 NULL 12692852143 04073 TRAMADOL 50 MG 1 ML SI IM IV AP 0.0000 4.1900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 75bcd473a0dc7c7a6751499b38a4a034 JOAQUIM 12692852143 NULL 12692852143 04073 TRAMADOL 50 MG 1 ML SI IM IV AP 0.0000 4.1900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 75bcd473a0dc7c7a6751499b38a4a034 JOAQUIM 12692852143 NULL 12692852143 51649 ALCOOL ETILICO 70 % ST TP ML 0.0000 0.0000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 75bcd473a0dc7c7a6751499b38a4a034 JOAQUIM 12692852143 NULL 12692852143 51710 CLORETO DE POTASSIO 15% 10 ML SI IV AP 0.0000 0.6850 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00124 LUVA CIRURGICA UN 0.0000 1.4475 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00124 LUVA CIRURGICA UN 0.0000 1.4475 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 26981 SORO FISIOLOGICO 0,9% 10 ML SI IV AP 0.0000 0.9600 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 26981 SORO FISIOLOGICO 0,9% 10 ML SI IV AP 0.0000 0.9600 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 26981 SORO FISIOLOGICO 0,9% 10 ML SI IV AP 0.0000 0.9600 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 26981 SORO FISIOLOGICO 0,9% 10 ML SI IV AP 0.0000 0.9600 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6875 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6875 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00487 RANITIDINA 25 MG/ML 2 ML SI IM IV AP 0.0000 0.9300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00487 RANITIDINA 25 MG/ML 2 ML SI IM IV AP 0.0000 0.9300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00487 RANITIDINA 25 MG/ML 2 ML SI IM IV AP 0.0000 0.9300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 51578 Frasco p/ alimentacao enteral 0.0000 2.4700 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 51584 ESPARADRAPO MICROPORE 0.0000 0.2560 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 54756 HIDANTAL 0.0000 0.1864 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 54756 HIDANTAL 0.0000 0.1864 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00796 FLORATIL (SACCHAROMYCES BOULARDII) 200 MG PO VO 0.0000 4.4400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4088 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4088 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4088 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4088 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4088 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6880 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6872 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6872 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6872 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6872 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1766 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1766 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1766 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1766 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4070 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4070 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4070 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.4000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 51508 ENCRISE (ARGIPRESSINA) 20 U/ML 1 ML SI IM IV SC AP 0.0000 20.1200 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 51584 ESPARADRAPO MICROPORE 0.0000 0.2560 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 51584 ESPARADRAPO MICROPORE 0.0000 0.2560 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cd2840524be5a3f1d0939f241e24f32b MARIA 12705908340 NULL 12705908340 00181 SULFATO DE MAGNESIO 100 MG/ML 10 ML SI IM IV 0.0000 0.9467 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cd2840524be5a3f1d0939f241e24f32b MARIA 12705908340 NULL 12705908340 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cd2840524be5a3f1d0939f241e24f32b MARIA 12705908340 NULL 12705908340 00090 SERINGA DESC 20 ML UN 0.0000 0.5365 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cd2840524be5a3f1d0939f241e24f32b MARIA 12705908340 NULL 12705908340 00090 SERINGA DESC 20 ML UN 0.0000 0.5367 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1775 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1775 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 00090 SERINGA DESC 20 ML UN 0.0000 0.5379 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 00090 SERINGA DESC 20 ML UN 0.0000 0.5400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 00090 SERINGA DESC 20 ML UN 0.0000 0.5379 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 01611 CLORETO DE POTASSIO 600 MG CA VO UN 0.0000 0.4867 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 01611 CLORETO DE POTASSIO 600 MG CA VO UN 0.0000 0.4867 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 01611 CLORETO DE POTASSIO 600 MG CA VO UN 0.0000 0.4867 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 26981 SORO FISIOLOGICO 0,9% 10 ML SI IV AP 0.0000 0.4800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.8078 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 51208 SORO RINGER SIMPLES 500 ML SI IV BS 0.0000 11.8800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1773 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1773 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1773 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1773 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1773 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1773 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1773 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1773 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 00090 SERINGA DESC 20 ML UN 0.0000 0.5400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 00090 SERINGA DESC 20 ML UN 0.0000 0.5400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4094 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4094 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4094 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4094 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4094 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 01496 FENITOINA 50 MG/ML 5 ML SI IM IV AP 0.0000 2.3400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 02246 HIDROCORTISONA 100 MG PO IM IV FA 0.0000 2.8300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 02246 HIDROCORTISONA 100 MG PO IM IV FA 0.0000 2.8300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 02246 HIDROCORTISONA 100 MG PO IM IV FA 0.0000 2.8300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 26981 SORO FISIOLOGICO 0,9% 10 ML SI IV AP 0.0000 0.4800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 26981 SORO FISIOLOGICO 0,9% 10 ML SI IV AP 0.0000 0.4800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 26981 SORO FISIOLOGICO 0,9% 10 ML SI IV AP 0.0000 0.9600 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 26981 SORO FISIOLOGICO 0,9% 10 ML SI IV AP 0.0000 0.9600 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 26981 SORO FISIOLOGICO 0,9% 10 ML SI IV AP 0.0000 0.9600 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 26981 SORO FISIOLOGICO 0,9% 10 ML SI IV AP 0.0000 0.9600 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 52392 SONDA DE ASPIRAÇAO TRAQUEAL C/ VALVULA UN 0.0000 0.9400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 09070 ACETILCISTEINA 600MG PO VO SA 0.0000 3.4950 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 09070 ACETILCISTEINA 600MG PO VO SA 0.0000 3.4950 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 09070 ACETILCISTEINA 600MG PO VO SA 0.0000 3.4950 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 15f461c0ca379f375bd9f8b18fbb101a ANA 12753753845 NULL 12753753845 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR APRESENTADO A MAIOR 1705
Glosa Min 2018-10-03 00:00:00.000000 1084117 15f461c0ca379f375bd9f8b18fbb101a ANA 12753753845 NULL 12753753845 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR APRESENTADO A MAIOR 1705
Glosa Min 2018-10-03 00:00:00.000000 1084117 15f461c0ca379f375bd9f8b18fbb101a ANA 12753753845 NULL 12753753845 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 15f461c0ca379f375bd9f8b18fbb101a ANA 12753753845 NULL 12753753845 55279 TRAMADOL 50 MG 1 ML SI IM IV AP 0.0000 4.1900 NULL COBRANCA DE MEDICAMENTO INCOMPATIVEL COM O RELATORIO TECNICO 2112
Glosa Min 2018-10-03 00:00:00.000000 1084117 15f461c0ca379f375bd9f8b18fbb101a ANA 12753753845 NULL 12753753845 00657 CEFAZOLINA 1 GR + DIL. 10 ML PO IM IV FA 0.0000 8.1300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00124 LUVA CIRURGICA UN 0.0000 1.4475 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4072 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4072 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4072 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4072 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4072 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4072 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4072 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4072 NULL VALOR APRESENTADO A MAIOR 1705
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4072 NULL VALOR APRESENTADO A MAIOR 1705
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4072 NULL VALOR APRESENTADO A MAIOR 1705
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 02355 AMOXICILINA 1 G + CLAVULANATO 200 MG + DIL. 10 ML 0.0000 36.4667 NULL COBRANCA DE MEDICAMENTO EM QUANTIDADE INCOMPATIVEL COM A PERMANENCIA 2107
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 02355 AMOXICILINA 1 G + CLAVULANATO 200 MG + DIL. 10 ML 0.0000 36.4667 NULL COBRANCA DE MEDICAMENTO EM QUANTIDADE INCOMPATIVEL COM A PERMANENCIA 2107
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 02355 AMOXICILINA 1 G + CLAVULANATO 200 MG + DIL. 10 ML 0.0000 36.4667 NULL COBRANCA DE MEDICAMENTO EM QUANTIDADE INCOMPATIVEL COM A PERMANENCIA 2107
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 02355 AMOXICILINA 1 G + CLAVULANATO 200 MG + DIL. 10 ML 0.0000 36.4667 NULL COBRANCA DE MEDICAMENTO EM QUANTIDADE INCOMPATIVEL COM A PERMANENCIA 2107
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 02355 AMOXICILINA 1 G + CLAVULANATO 200 MG + DIL. 10 ML 0.0000 36.4667 NULL COBRANCA DE MEDICAMENTO EM QUANTIDADE INCOMPATIVEL COM A PERMANENCIA 2107
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00090 SERINGA DESC 20 ML UN 0.0000 0.5367 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00090 SERINGA DESC 20 ML UN 0.0000 0.5367 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00090 SERINGA DESC 20 ML UN 0.0000 0.5400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00090 SERINGA DESC 20 ML UN 0.0000 0.5367 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00090 SERINGA DESC 20 ML UN 0.0000 0.5367 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00090 SERINGA DESC 20 ML UN 0.0000 1.0733 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 2e6b6f291f2df9beb1fbda6028678909 ANNA 12463693448 NULL 12463693448 00184 CLORETO DE POTASSIO 10% 10 ML SI IV AP 0.0000 0.3000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 2e6b6f291f2df9beb1fbda6028678909 ANNA 12463693448 NULL 12463693448 00184 CLORETO DE POTASSIO 10% 10 ML SI IV AP 0.0000 0.3000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 2e6b6f291f2df9beb1fbda6028678909 ANNA 12463693448 NULL 12463693448 20010141 Ecocardiograma Bidimensional com Mapeamento de Fluxo à Cores 0.0000 0.0000 NULL OPME PAGO A FORNECEDOR TERCEIRIZADO 2213
Glosa Min 2018-10-03 00:00:00.000000 1084117 2e6b6f291f2df9beb1fbda6028678909 ANNA 12463693448 NULL 12463693448 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 2e6b6f291f2df9beb1fbda6028678909 ANNA 12463693448 NULL 12463693448 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 2e6b6f291f2df9beb1fbda6028678909 ANNA 12463693448 NULL 12463693448 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 31d18d6607d9e742c53e748d6a55d740 CARLOS 12557779343 NULL 12557779343 101001 DIARIA DE ENFERMARIA 0.0000 173.3200 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 11325 EQUIPO MACRO-GOTAS FLEXIVEL C/ INJETOR LATERAL UN 0.0000 1.5900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 11325 EQUIPO MACRO-GOTAS FLEXIVEL C/ INJETOR LATERAL UN 0.0000 1.5900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00124 LUVA CIRURGICA UN 0.0000 1.4478 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00124 LUVA CIRURGICA UN 0.0000 1.4478 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6871 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6871 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6871 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6871 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 35382 COMPRESSAS DE GASES 7.5 X7,5 (11 FIOS ESTERIL) UN 0.0000 0.3000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 35382 COMPRESSAS DE GASES 7.5 X7,5 (11 FIOS ESTERIL) UN 0.0000 0.6000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 35382 COMPRESSAS DE GASES 7.5 X7,5 (11 FIOS ESTERIL) UN 0.0000 0.6000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 35382 COMPRESSAS DE GASES 7.5 X7,5 (11 FIOS ESTERIL) UN 0.0000 0.6000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00487 RANITIDINA 25 MG/ML 2 ML SI IM IV AP 0.0000 0.9300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00487 RANITIDINA 25 MG/ML 2 ML SI IM IV AP 0.0000 0.9300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.4000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.4000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.4000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.4000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.4000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1776 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1776 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 51379 SERINGA DESC 05 ML UN 0.0000 0.1900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 52392 SONDA DE ASPIRAÇAO TRAQUEAL C/ VALVULA UN 0.0000 1.8700 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 53774 SULFATO DE POLIMIXINA B GENERICO Restrito Hosp. 0.0000 11.8624 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 54157 EQUIPO P/ DIETA ENTERAL UN 0.0000 1.7000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 54157 EQUIPO P/ DIETA ENTERAL UN 0.0000 1.7000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00090 SERINGA DESC 20 ML UN 0.0000 0.5375 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00090 SERINGA DESC 20 ML UN 0.0000 0.5375 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00090 SERINGA DESC 20 ML UN 0.0000 0.5375 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.8074 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.8100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.8074 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.8074 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.8074 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.8074 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1775 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1775 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1775 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 51584 ESPARADRAPO MICROPORE 0.0000 0.3800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 51584 ESPARADRAPO MICROPORE 0.0000 0.3800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 51671 REPARIL (ESCINA + DIETILAMONIO) GL TP GR 0.0000 1.8800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 51671 REPARIL (ESCINA + DIETILAMONIO) GL TP GR 0.0000 0.0000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 00090 SERINGA DESC 20 ML UN 0.0000 0.5375 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd6f8d6c53ffe9bfd3aa9590ba500cc8 ILDA 12751932542 NULL 12751932542 04259 DRENO DE SUCCAO 0.0000 0.0960 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 00128 LUVA DE PROCEDIMENTO UNIDADE UN 0.0000 1.6700 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 01691 NISTATINA 100.000 UI/ML SU VO ML 0.0000 0.2950 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 01691 NISTATINA 100.000 UI/ML SU VO ML 0.0000 0.2950 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 01691 NISTATINA 100.000 UI/ML SU VO ML 0.0000 0.3000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 20691 HIDROCORTISONA 100 MG PO IM IV FA 0.0000 2.8300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 26981 SORO FISIOLOGICO 0,9% 10 ML SI IV AP 0.0000 0.1400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 26981 SORO FISIOLOGICO 0,9% 10 ML SI IV AP 0.0000 0.1400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 26981 SORO FISIOLOGICO 0,9% 10 ML SI IV AP 0.0000 0.1400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 26981 SORO FISIOLOGICO 0,9% 10 ML SI IV AP 0.0000 0.1400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 35382 COMPRESSAS DE GASES 7.5 X7,5 (11 FIOS ESTERIL) UN 0.0000 0.1200 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1765 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1765 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1765 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1765 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1765 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 51241 AGULHA 123X45 0.0000 0.1900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 51241 AGULHA 123X45 0.0000 0.1900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 51241 AGULHA 123X45 0.0000 0.1900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 51241 AGULHA 123X45 0.0000 0.1900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 51659 FENOTEROL 2 MG/ML 10 ML AE IN DS 0.0000 0.2567 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 00090 SERINGA DESC 20 ML UN 0.0000 0.5373 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 00090 SERINGA DESC 20 ML UN 0.0000 0.5373 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 00090 SERINGA DESC 20 ML UN 0.0000 0.5373 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 00090 SERINGA DESC 20 ML UN 0.0000 0.5373 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 61e4786d45edfdbf19b77fb2c6ce6b9c REINALDO 12754482747 NULL 12754482747 00172 SORO FISIOLOGICO 0,9% 500 ML SI IV BS 0.0000 4.7300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 61e4786d45edfdbf19b77fb2c6ce6b9c REINALDO 12754482747 NULL 12754482747 00172 SORO FISIOLOGICO 0,9% 500 ML SI IV BS 0.0000 4.7300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 61e4786d45edfdbf19b77fb2c6ce6b9c REINALDO 12754482747 NULL 12754482747 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 61e4786d45edfdbf19b77fb2c6ce6b9c REINALDO 12754482747 NULL 12754482747 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 61e4786d45edfdbf19b77fb2c6ce6b9c REINALDO 12754482747 NULL 12754482747 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 61e4786d45edfdbf19b77fb2c6ce6b9c REINALDO 12754482747 NULL 12754482747 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 61e4786d45edfdbf19b77fb2c6ce6b9c REINALDO 12754482747 NULL 12754482747 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.4000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 61e4786d45edfdbf19b77fb2c6ce6b9c REINALDO 12754482747 NULL 12754482747 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.4000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 61e4786d45edfdbf19b77fb2c6ce6b9c REINALDO 12754482747 NULL 12754482747 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 61e4786d45edfdbf19b77fb2c6ce6b9c REINALDO 12754482747 NULL 12754482747 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 102001 DIARIA DE APARTAMENTO 0.0000 288.8880 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 102001 DIARIA DE APARTAMENTO 0.0000 288.8880 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4072 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4072 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4072 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4072 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4072 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 51649 ALCOOL ETILICO 70 % ST TP ML 0.0000 0.0600 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 00091 SERINGA DESC 01 ML (INSULINA) UN 0.0000 0.3100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 081fdadb830fb547e83c43fabdb88372 ELZA 12377335349 NULL 12377335349 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 081fdadb830fb547e83c43fabdb88372 ELZA 12377335349 NULL 12377335349 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 081fdadb830fb547e83c43fabdb88372 ELZA 12377335349 NULL 12377335349 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 081fdadb830fb547e83c43fabdb88372 ELZA 12377335349 NULL 12377335349 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 081fdadb830fb547e83c43fabdb88372 ELZA 12377335349 NULL 12377335349 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 081fdadb830fb547e83c43fabdb88372 ELZA 12377335349 NULL 12377335349 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 081fdadb830fb547e83c43fabdb88372 ELZA 12377335349 NULL 12377335349 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 081fdadb830fb547e83c43fabdb88372 ELZA 12377335349 NULL 12377335349 01611 CLORETO DE POTASSIO 600 MG CA VO UN 0.0000 0.4900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 081fdadb830fb547e83c43fabdb88372 ELZA 12377335349 NULL 12377335349 01611 CLORETO DE POTASSIO 600 MG CA VO UN 0.0000 0.4900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 081fdadb830fb547e83c43fabdb88372 ELZA 12377335349 NULL 12377335349 02246 HIDROCORTISONA 100 MG PO IM IV FA 0.0000 5.6700 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 081fdadb830fb547e83c43fabdb88372 ELZA 12377335349 NULL 12377335349 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1800 NULL PAGO CONFORME RELATORIO DE AUDITORIA EXTERNA ― CONTA INICIAL 1717
Glosa Min 2018-10-03 00:00:00.000000 1084117 081fdadb830fb547e83c43fabdb88372 ELZA 12377335349 NULL 12377335349 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 35382 COMPRESSAS DE GASES 7.5 X7,5 (11 FIOS ESTERIL) UN 0.0000 0.6000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 51379 SERINGA DESC 05 ML UN 0.0000 0.1900 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 51379 SERINGA DESC 05 ML UN 0.0000 0.1900 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 51379 SERINGA DESC 05 ML UN 0.0000 0.1900 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 51379 SERINGA DESC 05 ML UN 0.0000 0.1900 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 51379 SERINGA DESC 05 ML UN 0.0000 0.1900 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 345c226bfea274af1372d41b0305a6c8 ALTINO 12720257940 NULL 12720257940 00493 BROMOPRIDA 5 MG/ML 2 ML SI IM IV AP 0.0000 2.7300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 345c226bfea274af1372d41b0305a6c8 ALTINO 12720257940 NULL 12720257940 00090 SERINGA DESC 20 ML UN 0.0000 0.5367 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 4668d2494ed6c4b2d18be299efcb26a2 JOAO 12469689344 NULL 12469689344 00123 LUVA CIRURGICA UN NULL 0.0000 NULL OPME INVALIDO 2201
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 00128 LUVA DE PROCEDIMENTO UNIDADE UN 0.0000 1.0000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR APRESENTADO A MAIOR 1705
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 00090 SERINGA DESC 20 ML UN 0.0000 0.5400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 00090 SERINGA DESC 20 ML UN 0.0000 0.5400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 00090 SERINGA DESC 20 ML UN 0.0000 0.5400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 00090 SERINGA DESC 20 ML UN 0.0000 0.5400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 00090 SERINGA DESC 20 ML UN 0.0000 0.5400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 01652 TRAMADOL 50 MG CP VO UN 0.0000 1.9300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 35382 COMPRESSAS DE GASES 7.5 X7,5 (11 FIOS ESTERIL) UN 0.0000 0.3000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 35382 COMPRESSAS DE GASES 7.5 X7,5 (11 FIOS ESTERIL) UN 0.0000 0.3000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 51588 ESPARADRAPO MICROPORE 50 X 10 CM CM 0.0000 0.7700 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 51589 ESPARADRAPO 10 X 4.5 CM CM 0.0000 0.4000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3fb5c891f31bb9efcb05395066127c52 ALAIDE 12636273441 NULL 12636273441 00487 RANITIDINA 25 MG/ML 2 ML SI IM IV AP 0.0000 0.0000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 610c198ec4c064687cf0524f147d3aed ROBERTO 12748814743 NULL 12748814743 16322 BENZILPENICILINA POTASSICA CRIST. 5.000.000 8.0700 8.0685 0.0017 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 6ccea6ac8c216c032723aee73a9f81c9 PRISCILA 12662249242 NULL 12662249242 32719 CEFAZOLINA 1 GR + DIL. 10 ML FA 8.1300 8.1275 0.0025 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 6ccea6ac8c216c032723aee73a9f81c9 PRISCILA 12662249242 NULL 12662249242 32719 CEFAZOLINA 1 GR + DIL. 10 ML FA 8.1300 8.1275 0.0025 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 6ccea6ac8c216c032723aee73a9f81c9 PRISCILA 12662249242 NULL 12662249242 32719 CEFAZOLINA 1 GR + DIL. 10 ML FA 16.2600 16.2550 0.0050 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 51378 SERINGA DESC 03 ML UN 0.1500 0.0600 0.0900 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 51378 SERINGA DESC 03 ML UN 0.1500 0.0600 0.0900 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00919 ALGODAO HIDROFILO BOLINHA UN 0.2600 0.1100 0.1500 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 03280 CLOREXIDINA 2 % ST TP ML 0.2700 0.1100 0.1600 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 03280 CLOREXIDINA 2 % ST TP ML 0.2700 0.1100 0.1600 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00127 LUVA DE PROCEDIMENTO UNIDADE UN 0.3300 0.1300 0.2000 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00127 LUVA DE PROCEDIMENTO UNIDADE UN 0.3300 0.1300 0.2000 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00127 LUVA DE PROCEDIMENTO UNIDADE UN 0.3300 0.1300 0.2000 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00127 LUVA DE PROCEDIMENTO UNIDADE UN 0.3300 0.1300 0.2000 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00127 LUVA DE PROCEDIMENTO UNIDADE UN 0.3300 0.1300 0.2000 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.4000 0.1600 0.2400 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.4000 0.1600 0.2400 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.4000 0.1600 0.2400 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.4000 0.1600 0.2400 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.4000 0.1600 0.2400 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 51589 ESPARADRAPO 10 X 4.5 CM CM 0.4000 0.1600 0.2400 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 54687 IODOPOVIDONA SD TP ML 0.4000 0.1600 0.2400 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00020010 Visita Hospitalar (Paciente Internado) 43.8000 17.1000 26.7000 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 07802 PIPERACILINA 4 G + TAZOBACTAM 500 MG PO IV FA 83.4500 32.5900 50.8600 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 07802 PIPERACILINA 4 G + TAZOBACTAM 500 MG PO IV FA 83.4500 32.5900 50.8600 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 02734 TARGOCID (TEICOPLANINA) 400 MG 3 ML PO IM IV FA 362.7200 141.6500 221.0700 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 01081197 5125859e8d2860b83822c41756a9b5bf ESMERALDA 12734516820 NULL 12734516820... 32040040 RX Articulação Coxo - Femural 0.0000 23.1250 NULL EXAME SEM REGISTRO DE EXECUCAO 2703
Glosa Min 2018-10-03 00:00:00.000000 01081197 5125859e8d2860b83822c41756a9b5bf ESMERALDA 12734516820 NULL 12734516820... 32040059 RX Coxa 0.0000 24.0850 NULL EXAME SEM REGISTRO DE EXECUCAO 2703
Glosa Min 2018-10-03 00:00:00.000000 01081197 e0b1f77dc9cff210f2fbead99c7ba4d4 MARCIO 12790052920 NULL 12790052920 00090 SERINGA DESC 20 ML UN NULL 0.0000 NULL OPME INVALIDO 2201
Glosa Min 2018-10-03 00:00:00.000000 01081197 3af14fcc4f764a77ed38b3d2e81bcc76 JOAO 12687535922 NULL 12687535922 00220 ELETRODO DESCARTAVEL (UTI) UN NULL 0.0000 NULL OPME INVALIDO 2201
Glosa Min 2018-10-03 00:00:00.000000 1084117 16b1e9f62f247f02ad5cac910ee15b4e BERCHOLINA 12631612848 NULL 12631612848 00171 SORO FISIOLOGICO 0,9% 250 ML SI IV BS 3.9400 3.7600 0.1800 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 16b1e9f62f247f02ad5cac910ee15b4e BERCHOLINA 12631612848 NULL 12631612848 04073 TRAMADOL 50 MG 1 ML SI IM IV AP 4.1900 4.0000 0.1900 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 16b1e9f62f247f02ad5cac910ee15b4e BERCHOLINA 12631612848 NULL 12631612848 04073 TRAMADOL 50 MG 1 ML SI IM IV AP 4.1900 3.9900 0.2000 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 16b1e9f62f247f02ad5cac910ee15b4e BERCHOLINA 12631612848 NULL 12631612848 22421 PIPERACILINA 2 G + TAZOBACTAM 250 MG 30 ML PO IV 55.3400 52.7400 2.6000 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 16b1e9f62f247f02ad5cac910ee15b4e BERCHOLINA 12631612848 NULL 12631612848 20080 LINEZOLIDA 2 MG/ML 300 ML SI IV BS 174.9800 166.7800 8.2000 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 16b1e9f62f247f02ad5cac910ee15b4e BERCHOLINA 12631612848 NULL 12631612848 20080 LINEZOLIDA 2 MG/ML 300 ML SI IV BS 174.9800 166.7800 8.2000 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 16b1e9f62f247f02ad5cac910ee15b4e BERCHOLINA 12631612848 NULL 12631612848 20080 LINEZOLIDA 2 MG/ML 300 ML SI IV BS 174.9800 166.7800 8.2000 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 01081195 dc9eaa384ae79bd374f6eb26ed4e6234 MARCELO 12751149116 NULL 12751149116 00010014 CONSULTA EM CONSULTORIO MEDICO 0.0000 0.0000 50.0000 GUIA DE CONSULTA NAO EXECUTADA 0622
Glosa Min 2018-10-03 00:00:00.000000 01081195 1f5f0c7f56ddf383ee0b633380db5501 CLAUDIA 12811247910 NULL 12811247910 00010014 CONSULTA EM CONSULTORIO MEDICO 0.0000 0.0000 50.0000 GUIA DE CONSULTA NAO EXECUTADA 0622
Glosa Min 2018-10-03 00:00:00.000000 01081195 8e66184ab6a0f3f9076a2217f2e6fe1d AGUINALDO 12761336014 NULL 12761336014 00010014 CONSULTA EM CONSULTORIO MEDICO 0.0000 0.0000 50.0000 GUIA DE CONSULTA NAO EXECUTADA 0622
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 00817 ALGODAO HIDROFILO BOLINHA UN 0.5100 0.2600 0.2500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.3500 0.0000 0.3500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 00817 ALGODAO HIDROFILO BOLINHA UN 0.5100 0.2600 0.2500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 37761 ALCOOL ETILICO 70 % ST TP ML 0.0600 0.0300 0.0300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 d17b3c5ae418d82694895a326dee545a ODILIA 12670516743 NULL 12670516743 33219 LUVA DE PROCEDIMENTO UNIDADE UN 1.0000 0.6700 0.3300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 00817 ALGODAO HIDROFILO BOLINHA UN 0.2600 0.1300 0.1300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 00817 ALGODAO HIDROFILO BOLINHA UN 0.5100 0.1300 0.3800 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 00817 ALGODAO HIDROFILO BOLINHA UN 0.5100 0.2600 0.2500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 02739 BOLSA COLETORA (SISTEMA FECHADO) UN 5.9300 0.0000 5.9300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 19763 SONDA FOLEY 2 VIAS Nş 16 UN 3.8200 0.0000 3.8200 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 08460 EQUIPO P/ SOLUÇOES FOTOSSENSIVEIS UN 16.4000 0.0000 16.4000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 37761 ALCOOL ETILICO 70 % ST TP ML 0.0300 0.0200 0.0100 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 08648 ESPARADRAPO 10 X 4.5 CM CM 0.4000 0.2000 0.2000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.4000 0.4100 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 08648 ESPARADRAPO 10 X 4.5 CM CM 0.4000 0.2000 0.2000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 11193 CLOREXIDINA 2 % ST TP ML 1.6000 0.5300 1.0700 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 752c651cb4fd049e19c685f87fbe8bdc EDUARDO 12765990646 NULL 12765990646 08435 EQUIPO P/ BOMBA DE INFUSAO ENTERAL / PARENT 40.5600 20.2800 20.2800 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 752c651cb4fd049e19c685f87fbe8bdc EDUARDO 12765990646 NULL 12765990646 00817 ALGODAO HIDROFILO BOLINHA UN 0.5100 0.1300 0.3800 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3d5131ef222e15b77c298e3372afc496 MARIA 12665213047 NULL 12665213047 58750 AGULHA P/ PUNÇAO PERCUTANEA UN 82.0000 0.0000 82.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 33219 LUVA DE PROCEDIMENTO UNIDADE UN 1.0000 0.6700 0.3300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 05975 COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER 0.0300 0.0000 0.0300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 37761 ALCOOL ETILICO 70 % ST TP ML 0.0300 0.0200 0.0100 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00817 ALGODAO HIDROFILO BOLINHA UN 0.2600 0.1300 0.1300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 33219 LUVA DE PROCEDIMENTO UNIDADE UN 1.0000 0.6700 0.3300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 345c226bfea274af1372d41b0305a6c8 ALTINO 12720257940 NULL 12720257940 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1000 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 345c226bfea274af1372d41b0305a6c8 ALTINO 12720257940 NULL 12720257940 13404 OMEPRAZOL 40 MG + DIL. 10 ML PO IV FA 19.5800 19.5750 0.0050 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 345c226bfea274af1372d41b0305a6c8 ALTINO 12720257940 NULL 12720257940 13404 OMEPRAZOL 40 MG + DIL. 10 ML PO IV FA 19.5800 19.5750 0.0050 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 31d18d6607d9e742c53e748d6a55d740 CARLOS 12557779343 NULL 12557779343 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1760 0.0040 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 31d18d6607d9e742c53e748d6a55d740 CARLOS 12557779343 NULL 12557779343 07269 DIPIRONA 500 MG/ML 2 ML SI IV IM AP 0.6900 0.6860 0.0040 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 0405a686318e3fc262f105ed4be24d95 CARMELITA 12687161644 NULL 12687161644 07269 DIPIRONA 500 MG/ML 2 ML SI IV IM AP 0.6900 0.6873 0.0027 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 ea6abb4182a48f0934f3e9eb5affa056 DILVA 12697455440 NULL 12697455440 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1750 0.0050 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 500e4b8f04552b423f9db8f81073659f FIDELIS 12763450340 NULL 12763450340 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 6.8200 6.8100 0.0000 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 500e4b8f04552b423f9db8f81073659f FIDELIS 12763450340 NULL 12763450340 30511 CEFALOTINA 1 G FA + DIL. 10 ML FA 4.6600 4.6500 0.0000 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 27600 ONDANSETRONA 2 MG/ML 4 ML SI IM IV AP 13.5300 0.0000 13.5300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 27600 ONDANSETRONA 2 MG/ML 4 ML SI IM IV AP 13.5300 0.0000 13.5300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 27600 ONDANSETRONA 2 MG/ML 4 ML SI IM IV AP 13.5300 0.0000 13.5300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 27600 ONDANSETRONA 2 MG/ML 4 ML SI IM IV AP 13.5300 0.0000 13.5300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 08664 ESPARADRAPO MICROPORE 50 X 10 CM CM 0.2600 0.2562 0.0038 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 52353 ABAIXADOR DE LINGUA UN 0.0500 0.0000 0.0500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 17310 IODOPOVIDONA ALCOOLICA SL TP ML 0.6000 0.0000 0.6000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 31d18d6607d9e742c53e748d6a55d740 CARLOS 12557779343 NULL 12557779343 08664 ESPARADRAPO MICROPORE 50 X 10 CM CM 0.7700 0.5100 0.2600 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 31d18d6607d9e742c53e748d6a55d740 CARLOS 12557779343 NULL 12557779343 11193 CLOREXIDINA 2 % ST TP ML 2.6600 1.8600 0.8000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 31d18d6607d9e742c53e748d6a55d740 CARLOS 12557779343 NULL 12557779343 08664 ESPARADRAPO MICROPORE 50 X 10 CM CM 2.5600 0.5100 2.0500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 32891 EQUIPO POLIFIX 2ş VIAS UN 5.1000 2.5500 2.5500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 21822 TRAMADOL 50 MG 1 ML SI IM IV AP 4.1900 0.0000 4.1900 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 32891 EQUIPO POLIFIX 2ş VIAS UN 5.1000 0.0000 5.1000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 32891 EQUIPO POLIFIX 2ş VIAS UN 2.5500 0.0000 2.5500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 00817 ALGODAO HIDROFILO BOLINHA UN 0.2600 0.1300 0.1300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 f15dde67c6bce10519b3c6376759939c JOAO 12625226846 NULL 12625226846 08648 ESPARADRAPO 10 X 4.5 CM CM 2.0000 1.0200 0.9800 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 33219 LUVA DE PROCEDIMENTO UNIDADE UN 1.0000 0.6700 0.3300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 00817 ALGODAO HIDROFILO BOLINHA UN 0.2600 0.1300 0.1300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 37761 ALCOOL ETILICO 70 % ST TP ML 0.0300 0.0200 0.0100 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 33219 LUVA DE PROCEDIMENTO UNIDADE UN 1.0000 0.6700 0.3300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 37761 ALCOOL ETILICO 70 % ST TP ML 0.0300 0.0200 0.0100 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 00817 ALGODAO HIDROFILO BOLINHA UN 0.2600 0.1300 0.1300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 37761 ALCOOL ETILICO 70 % ST TP ML 0.0600 0.0200 0.0400 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 37761 ALCOOL ETILICO 70 % ST TP ML 0.0600 0.0200 0.0400 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 19160 SERINGA DESC 20 ML UN 0.5400 0.0000 0.5400 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 00817 ALGODAO HIDROFILO BOLINHA UN 0.5100 0.2600 0.2500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 00817 ALGODAO HIDROFILO BOLINHA UN 0.5100 0.2600 0.2500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 00817 ALGODAO HIDROFILO BOLINHA UN 0.5100 0.2600 0.2500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 37680 FIO MONONYLON 0 C/ AGULHA 2,0 3/8 14505T U 14.9100 7.4600 7.4500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 00817 ALGODAO HIDROFILO BOLINHA UN 0.5100 0.2600 0.2500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cd2840524be5a3f1d0939f241e24f32b MARIA 12705908340 NULL 12705908340 00817 ALGODAO HIDROFILO BOLINHA UN 0.2600 0.1300 0.1300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cd2840524be5a3f1d0939f241e24f32b MARIA 12705908340 NULL 12705908340 53660 EQUIPO MACRO-GOTAS FLEXIVEL C/ INJETOR LATE 1.5900 0.0000 1.5900 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cd2840524be5a3f1d0939f241e24f32b MARIA 12705908340 NULL 12705908340 37761 ALCOOL ETILICO 70 % ST TP ML 0.0300 0.0200 0.0100 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cd2840524be5a3f1d0939f241e24f32b MARIA 12705908340 NULL 12705908340 52582 CATETER OXIGENIO TIPO OCULOS UN 1.0000 0.0000 1.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12603877940 NULL 12603877940 00817 ALGODAO HIDROFILO BOLINHA UN 0.2600 0.1300 0.1300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12603877940 NULL 12603877940 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.3100 0.0000 0.3100 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12603877940 NULL 12603877940 19143 SERINGA DESC 05 ML UN 0.5800 0.0000 0.5800 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12603877940 NULL 12603877940 33219 LUVA DE PROCEDIMENTO UNIDADE UN 1.3300 0.6700 0.6600 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12603877940 NULL 12603877940 00817 ALGODAO HIDROFILO BOLINHA UN 0.2600 0.1300 0.1300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12603877940 NULL 12603877940 00817 ALGODAO HIDROFILO BOLINHA UN 0.2600 0.1300 0.1300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12603877940 NULL 12603877940 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.4100 0.1000 0.3100 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12603877940 NULL 12603877940 11193 CLOREXIDINA 2 % ST TP ML 2.1300 1.3300 0.8000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12603877940 NULL 12603877940 13757 IODOPOVIDONA SD TP ML 0.4000 0.0000 0.4000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12603877940 NULL 12603877940 33219 LUVA DE PROCEDIMENTO UNIDADE UN 2.3300 0.6700 1.6600 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12603877940 NULL 12603877940 33219 LUVA DE PROCEDIMENTO UNIDADE UN 2.3300 0.6700 1.6600 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12603877940 NULL 12603877940 00817 ALGODAO HIDROFILO BOLINHA UN 0.2600 0.1300 0.1300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12603877940 NULL 12603877940 22748 LIDOCAINA 2% GE TP OU GR 2.5900 1.3000 1.2900 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12603877940 NULL 12603877940 07269 DIPIRONA 500 MG/ML 2 ML SI IV IM AP 2.0600 1.3700 0.6900 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 33219 LUVA DE PROCEDIMENTO UNIDADE UN 1.0000 0.6700 0.3300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 02461 FENOTEROL 2 MG/ML 10 ML AE IN DS 2.1300 0.0000 2.1300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 33219 LUVA DE PROCEDIMENTO UNIDADE UN 1.0000 0.6700 0.3300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 02461 FENOTEROL 2 MG/ML 10 ML AE IN DS 2.5500 0.0000 2.5500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 818a6f2e549cc6a60aa20f9d0595eec9 ANTONIO 12565134343 NULL 12565134343 19160 SERINGA DESC 20 ML UN 0.5400 0.5371 0.0029 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 a050ed50115d2a6dd0b15b99b39063da ARI 12676101147 NULL 12676101147 13404 OMEPRAZOL 40 MG + DIL. 10 ML PO IV FA 19.5800 19.5750 0.0050 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 edffb7fef608512400078fdf75991573 CARLA 12728631049 NULL 12728631049 32719 CEFAZOLINA 1 GR + DIL. 10 ML FA 16.2600 16.2500 0.0000 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 edffb7fef608512400078fdf75991573 CARLA 12728631049 NULL 12728631049 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1760 0.0040 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 9be01c766c547e19f866de2a24c5d27c DORALICE 12676142945 NULL 12676142945 33219 LUVA DE PROCEDIMENTO UNIDADE UN 1.6700 1.6600 0.0000 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 39df67956a358bf1eab89803158d25dd HELENA 12655863342 NULL 12655863342 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1750 0.0050 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 39df67956a358bf1eab89803158d25dd HELENA 12655863342 NULL 12655863342 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1750 0.0050 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 39df67956a358bf1eab89803158d25dd HELENA 12655863342 NULL 12655863342 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1750 0.0050 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 cb57fc8e673b7c8bc339e1fe25d70cd5 HELIO 12661165148 NULL 12661165148 07269 DIPIRONA 500 MG/ML 2 ML SI IV IM AP 0.6900 0.6867 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 9d06dbe3a8516628c3a045963dfb9c42 INAN 12623574546 NULL 12623574546 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1758 0.0042 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 9d06dbe3a8516628c3a045963dfb9c42 INAN 12623574546 NULL 12623574546 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1757 0.0043 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 4668d2494ed6c4b2d18be299efcb26a2 JOAO 12469689344 NULL 12469689344 22896 CEFUROXIMA 750 MG + DIL. 6 ML PO IM IV FA 78.3800 78.3700 0.0000 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 4668d2494ed6c4b2d18be299efcb26a2 JOAO 12469689344 NULL 12469689344 05975 COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER 0.0300 0.0000 0.0300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 4668d2494ed6c4b2d18be299efcb26a2 JOAO 12469689344 NULL 12469689344 05975 COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER 0.0300 0.0000 0.0300 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 4668d2494ed6c4b2d18be299efcb26a2 JOAO 12469689344 NULL 12469689344 17817 PROLOPA (LEVODOPA 200 MG + BENSERAZIDA 50 M 2.1200 2.1150 0.0050 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 02461 FENOTEROL 2 MG/ML 10 ML AE IN DS 0.2600 0.2567 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 01081195 b79a14169b7b425d375290c6efbc8814 JOSE 12742536611 NULL 12742536611 00010014 CONSULTA EM CONSULTORIO MEDICO 0.0000 35.0000 NULL ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 01081195 754284f4c7edf7cb27a629b4949481b5 MARIA 12743093713 NULL 12743093713 00010014 CONSULTA EM CONSULTORIO MEDICO 0.0000 35.0000 NULL ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 25030019 DISTURBIOS CIRCULATORIOS ARTERIO VE 0.0000 160.4800 NULL ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 de1a8276d878171456d7fc8f6dcd2457 ABEL 12764206443 NULL 12764206443 07269 DIPIRONA 500 MG/ML 2 ML SI IV IM AP 0.6900 0.6860 0.0040 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 de1a8276d878171456d7fc8f6dcd2457 ABEL 12764206443 NULL 12764206443 07269 DIPIRONA 500 MG/ML 2 ML SI IV IM AP 0.6900 0.6860 0.0040 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1770 0.0030 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1770 0.0030 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1770 0.0030 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1770 0.0030 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1770 0.0030 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1770 0.0030 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1770 0.0030 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8072 0.0028 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8072 0.0028 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8072 0.0028 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8072 0.0028 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8072 0.0028 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8072 0.0028 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8072 0.0028 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 09733 ACETILCISTEINA 600MG PO VO SA 3.5000 3.4955 0.0045 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 09733 ACETILCISTEINA 600MG PO VO SA 3.5000 3.4955 0.0045 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4083 0.0017 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 08664 ESPARADRAPO MICROPORE 50 X 10 CM CM 0.2600 0.2561 0.0039 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 08664 ESPARADRAPO MICROPORE 50 X 10 CM CM 0.7700 0.7682 0.0018 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 08664 ESPARADRAPO MICROPORE 50 X 10 CM CM 0.7700 0.7682 0.0018 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 20672 SORO RINGER SIMPLES 500 ML SI IV BS 5.9400 5.9367 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 42358 FUROSEMIDA 10 MG/ML 2 ML SI IM IV AP 0.6000 0.5986 0.0014 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4066 0.0034 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4078 0.0022 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4078 0.0022 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4078 0.0022 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4078 0.0022 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 33227 LUVA CIRURGICA PAR UN 1.4500 1.4476 0.0024 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 33227 LUVA CIRURGICA PAR UN 1.4500 1.4476 0.0024 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 33227 LUVA CIRURGICA PAR UN 1.4500 1.4476 0.0024 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 33227 LUVA CIRURGICA PAR UN 1.4500 1.4476 0.0024 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1038 -0.0038 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1038 -0.0038 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1038 -0.0038 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 b288bbcfb9aecab51bcb0dba62ca0059 IVONETE 12743730847 NULL 12743730847 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4067 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 b288bbcfb9aecab51bcb0dba62ca0059 IVONETE 12743730847 NULL 12743730847 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4067 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 b288bbcfb9aecab51bcb0dba62ca0059 IVONETE 12743730847 NULL 12743730847 19160 SERINGA DESC 20 ML UN 0.5400 0.5367 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 b288bbcfb9aecab51bcb0dba62ca0059 IVONETE 12743730847 NULL 12743730847 19160 SERINGA DESC 20 ML UN 0.5400 0.5367 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 b288bbcfb9aecab51bcb0dba62ca0059 IVONETE 12743730847 NULL 12743730847 19160 SERINGA DESC 20 ML UN 0.5400 0.5367 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 b288bbcfb9aecab51bcb0dba62ca0059 IVONETE 12743730847 NULL 12743730847 19160 SERINGA DESC 20 ML UN 0.5400 0.5367 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12558131243 NULL 12558131243 05975 COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER 0.9000 0.3800 0.5200 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1800 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1700 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 08664 ESPARADRAPO MICROPORE 50 X 10 CM CM 0.7700 0.0000 0.7700 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4084 0.0016 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4084 0.0016 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4084 0.0016 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4084 0.0016 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4084 0.0016 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4084 0.0016 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4084 0.0016 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4084 0.0016 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4084 0.0016 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4084 0.0016 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1036 -0.0036 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 18457 REPARIL (ESCINA + DIETILAMONIO) GL TP GR 3.7500 0.0000 3.7500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 18457 REPARIL (ESCINA + DIETILAMONIO) GL TP GR 3.7500 0.0000 3.7500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 19160 SERINGA DESC 20 ML UN 0.5400 0.5384 0.0016 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 05975 COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER 0.3000 0.0000 0.3000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 32204 CLORETO DE SODIO 0,9% 10 ML SI IV AP 0.4800 0.4800 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8067 0.0033 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8067 0.0033 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8067 0.0033 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8067 0.0033 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8067 0.0033 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 32204 CLORETO DE SODIO 0,9% 10 ML SI IV AP 0.4800 0.0000 0.4800 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 32204 CLORETO DE SODIO 0,9% 10 ML SI IV AP 0.4800 0.0000 0.4800 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 32204 CLORETO DE SODIO 0,9% 10 ML SI IV AP 0.9600 0.0000 0.9600 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 33219 LUVA DE PROCEDIMENTO UNIDADE UN 0.3300 0.0000 0.3300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 53660 EQUIPO MACRO-GOTAS FLEXIVEL C/ INJETOR LATE 1.5900 0.0000 1.5900 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 32204 CLORETO DE SODIO 0,9% 10 ML SI IV AP 0.9600 0.9600 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 32204 CLORETO DE SODIO 0,9% 10 ML SI IV AP 0.4800 0.0000 0.4800 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 32204 CLORETO DE SODIO 0,9% 10 ML SI IV AP 0.4800 0.0000 0.4800 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 32204 CLORETO DE SODIO 0,9% 10 ML SI IV AP 0.4800 0.0000 0.4800 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e715e2ae28a6229c8609756d3298bf52 MARIA 12734221144 NULL 12734221144 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1750 0.0050 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 05975 COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER 0.3000 0.0000 0.3000 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 05975 COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER 0.6000 0.7667 -0.1667 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 05975 COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER 0.3000 0.1918 0.1082 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 05975 COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER 0.6000 0.7673 -0.1673 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 33537 PIPERACILINA 2 G + TAZOBACTAM 250 MG 30 ML 55.3400 55.3375 0.0025 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 33537 PIPERACILINA 2 G + TAZOBACTAM 250 MG 30 ML 55.3400 55.3375 0.0025 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 33537 PIPERACILINA 2 G + TAZOBACTAM 250 MG 30 ML 55.3400 55.3375 0.0025 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 33537 PIPERACILINA 2 G + TAZOBACTAM 250 MG 30 ML 55.3400 55.3375 0.0025 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 33537 PIPERACILINA 2 G + TAZOBACTAM 250 MG 30 ML 55.3400 55.3375 0.0025 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 42358 FUROSEMIDA 10 MG/ML 2 ML SI IM IV AP 1.2000 1.1964 0.0036 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4061 0.0039 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4061 0.0039 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4061 0.0039 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4061 0.0039 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 33227 LUVA CIRURGICA PAR UN 1.4500 1.4477 0.0023 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 33227 LUVA CIRURGICA PAR UN 1.4500 1.4477 0.0023 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 33227 LUVA CIRURGICA PAR UN 1.4500 1.4477 0.0023 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 33227 LUVA CIRURGICA PAR UN 1.4500 1.4477 0.0023 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 08664 ESPARADRAPO MICROPORE 50 X 10 CM CM 0.7700 0.0000 0.7700 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 08664 ESPARADRAPO MICROPORE 50 X 10 CM CM 0.7700 0.7650 0.0050 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 19135 SERINGA DESC 03 ML UN 0.1500 0.1500 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.2100 0.2057 0.0043 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.2100 0.2057 0.0043 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1772 0.0028 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1772 0.0028 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1772 0.0028 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1772 0.0028 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1772 0.0028 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cd2840524be5a3f1d0939f241e24f32b MARIA 12705908340 NULL 12705908340 32204 CLORETO DE SODIO 0,9% 10 ML SI IV AP 0.4800 0.0000 0.4800 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cd2840524be5a3f1d0939f241e24f32b MARIA 12705908340 NULL 12705908340 32204 CLORETO DE SODIO 0,9% 10 ML SI IV AP 0.4800 0.4800 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cd2840524be5a3f1d0939f241e24f32b MARIA 12705908340 NULL 12705908340 32204 CLORETO DE SODIO 0,9% 10 ML SI IV AP 0.4800 0.0000 0.4800 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cd2840524be5a3f1d0939f241e24f32b MARIA 12705908340 NULL 12705908340 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1764 0.0036 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cd2840524be5a3f1d0939f241e24f32b MARIA 12705908340 NULL 12705908340 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1764 0.0036 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cd2840524be5a3f1d0939f241e24f32b MARIA 12705908340 NULL 12705908340 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1764 0.0036 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 d17b3c5ae418d82694895a326dee545a ODILIA 12670516743 NULL 12670516743 30376 BROMETO DE IPRATROPIO 0,25MG/ML SL IN GT 0.4000 0.0000 0.4000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 d17b3c5ae418d82694895a326dee545a ODILIA 12670516743 NULL 12670516743 30376 BROMETO DE IPRATROPIO 0,25MG/ML SL IN GT 0.4000 0.0000 0.4000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 d17b3c5ae418d82694895a326dee545a ODILIA 12670516743 NULL 12670516743 32204 CLORETO DE SODIO 0,9% 10 ML SI IV AP 0.4800 0.0000 0.4800 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1766 0.0034 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1766 0.0034 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1766 0.0034 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1766 0.0034 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1766 0.0034 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 8a5ecfde671848d05ac757e0112e689c TEREZINHA 12700337042 NULL 12700337042 09733 ACETILCISTEINA 600MG PO VO SA 3.5000 3.4967 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 8a5ecfde671848d05ac757e0112e689c TEREZINHA 12700337042 NULL 12700337042 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4071 0.0029 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 8a5ecfde671848d05ac757e0112e689c TEREZINHA 12700337042 NULL 12700337042 19160 SERINGA DESC 20 ML UN 0.5400 0.5376 0.0024 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 8a5ecfde671848d05ac757e0112e689c TEREZINHA 12700337042 NULL 12700337042 19160 SERINGA DESC 20 ML UN 0.5400 0.5376 0.0024 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 8a5ecfde671848d05ac757e0112e689c TEREZINHA 12700337042 NULL 12700337042 19160 SERINGA DESC 20 ML UN 0.5400 0.5376 0.0024 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 8a5ecfde671848d05ac757e0112e689c TEREZINHA 12700337042 NULL 12700337042 19160 SERINGA DESC 20 ML UN 0.5400 0.5376 0.0024 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 8a5ecfde671848d05ac757e0112e689c TEREZINHA 12700337042 NULL 12700337042 19160 SERINGA DESC 20 ML UN 0.5400 0.5376 0.0024 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 8a5ecfde671848d05ac757e0112e689c TEREZINHA 12700337042 NULL 12700337042 19160 SERINGA DESC 20 ML UN 0.5400 0.5376 0.0024 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 8a5ecfde671848d05ac757e0112e689c TEREZINHA 12700337042 NULL 12700337042 19160 SERINGA DESC 20 ML UN 0.5400 0.5376 0.0024 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 70cf23c63f890f0b61da2542c3e13a09 TIAGO 12741864645 NULL 12741864645 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1762 0.0038 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 70cf23c63f890f0b61da2542c3e13a09 TIAGO 12741864645 NULL 12741864645 19160 SERINGA DESC 20 ML UN 0.5400 0.5367 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 70cf23c63f890f0b61da2542c3e13a09 TIAGO 12741864645 NULL 12741864645 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4075 0.0025 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 70cf23c63f890f0b61da2542c3e13a09 TIAGO 12741864645 NULL 12741864645 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4075 0.0025 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 08648 ESPARADRAPO 10 X 4.5 CM CM 0.4000 0.0000 0.4000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4070 0.0030 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4070 0.0030 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 33227 LUVA CIRURGICA PAR UN 1.4500 1.4476 0.0024 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 33227 LUVA CIRURGICA PAR UN 1.4500 1.4476 0.0024 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 0111beed375944f60c7ad4a7fd4874f8 WALDIR 12746025744 NULL 12746025744 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8074 0.0026 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 0111beed375944f60c7ad4a7fd4874f8 WALDIR 12746025744 NULL 12746025744 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 1.6200 1.6147 0.0053 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 0111beed375944f60c7ad4a7fd4874f8 WALDIR 12746025744 NULL 12746025744 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 1.6200 1.6147 0.0053 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 0111beed375944f60c7ad4a7fd4874f8 WALDIR 12746025744 NULL 12746025744 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 1.6200 1.6147 0.0053 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 0111beed375944f60c7ad4a7fd4874f8 WALDIR 12746025744 NULL 12746025744 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 1.6200 1.6147 0.0053 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 0111beed375944f60c7ad4a7fd4874f8 WALDIR 12746025744 NULL 12746025744 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4076 0.0024 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 0111beed375944f60c7ad4a7fd4874f8 WALDIR 12746025744 NULL 12746025744 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4076 0.0024 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 0111beed375944f60c7ad4a7fd4874f8 WALDIR 12746025744 NULL 12746025744 19160 SERINGA DESC 20 ML UN 0.5400 0.5379 0.0021 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 0111beed375944f60c7ad4a7fd4874f8 WALDIR 12746025744 NULL 12746025744 19160 SERINGA DESC 20 ML UN 0.5400 0.5379 0.0021 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 0111beed375944f60c7ad4a7fd4874f8 WALDIR 12746025744 NULL 12746025744 19160 SERINGA DESC 20 ML UN 0.5400 0.5379 0.0021 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 0111beed375944f60c7ad4a7fd4874f8 WALDIR 12746025744 NULL 12746025744 19160 SERINGA DESC 20 ML UN 0.5400 0.5379 0.0021 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 37761 ALCOOL ETILICO 70 % ST TP ML 0.0300 0.0000 0.0300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 37761 ALCOOL ETILICO 70 % ST TP ML 0.0600 0.0600 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 00817 ALGODAO HIDROFILO BOLINHA UN 0.2600 0.0000 0.2600 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 00817 ALGODAO HIDROFILO BOLINHA UN 0.5100 0.2600 0.2500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 52353 ABAIXADOR DE LINGUA UN 0.0500 0.0267 0.0233 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 00817 ALGODAO HIDROFILO BOLINHA UN 0.2600 0.0000 0.2600 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 37761 ALCOOL ETILICO 70 % ST TP ML 0.0300 0.0000 0.0300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 00817 ALGODAO HIDROFILO BOLINHA UN 0.2600 0.0000 0.2600 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 27596 TIRA TESTE PARA GLICOSE UN 1.0400 1.0400 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 05975 COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER 0.3000 0.0000 0.3000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 05975 COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER 0.3000 0.3000 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 05975 COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER 0.3000 0.0000 0.3000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12647284040 NULL 12647284040 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4086 0.0014 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12662414945 NULL 12662414945 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1750 0.0050 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12662414945 NULL 12662414945 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1750 0.0050 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12662414945 NULL 12662414945 33219 LUVA DE PROCEDIMENTO UNIDADE UN 0.6700 0.6657 0.0043 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12662414945 NULL 12662414945 13404 OMEPRAZOL 40 MG + DIL. 10 ML PO IV FA 19.5800 19.5750 0.0050 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12662414945 NULL 12662414945 19445 CLORETO DE POTASSIO 600 MG CA VO UN 0.4900 0.4867 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 05975 COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER 0.3000 0.0000 0.3000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 05975 COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER 0.3000 0.0000 0.3000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 05975 COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER 0.3000 0.0000 0.3000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 05975 COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER 0.3000 0.0000 0.3000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 33227 LUVA CIRURGICA PAR UN 1.4500 1.4460 0.0040 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 33227 LUVA CIRURGICA PAR UN 1.4500 1.4476 0.0024 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 33227 LUVA CIRURGICA PAR UN 1.4500 1.4476 0.0024 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 33219 LUVA DE PROCEDIMENTO UNIDADE UN 0.3300 0.0000 0.3300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 33219 LUVA DE PROCEDIMENTO UNIDADE UN 1.6700 1.6700 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1770 0.0030 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1770 0.0030 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1770 0.0030 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1770 0.0030 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1770 0.0030 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1770 0.0030 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1770 0.0030 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1770 0.0030 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1770 0.0030 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 26981 SORO FISIOLOGICO 0,9% 10 ML SI IV AP 0.0000 0.9600 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 26981 SORO FISIOLOGICO 0,9% 10 ML SI IV AP 0.0000 0.9600 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 26981 SORO FISIOLOGICO 0,9% 10 ML SI IV AP 0.0000 0.9600 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ea4ad2636c25d8e3dbb569ae62db71e7 IONE 12489788840 NULL 12489788840 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.4000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ea4ad2636c25d8e3dbb569ae62db71e7 IONE 12489788840 NULL 12489788840 00737 CEFTRIAXONA IV 1G + DIL. 10 ML PO IV FA 0.0000 27.0600 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ea4ad2636c25d8e3dbb569ae62db71e7 IONE 12489788840 NULL 12489788840 00737 CEFTRIAXONA IV 1G + DIL. 10 ML PO IV FA 0.0000 27.0600 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 d17b3c5ae418d82694895a326dee545a ODILIA 12670516743 NULL 12670516743 102001 DIARIA DE APARTAMENTO 0.0000 288.8881 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 d17b3c5ae418d82694895a326dee545a ODILIA 12670516743 NULL 12670516743 102001 DIARIA DE APARTAMENTO 0.0000 288.8882 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 d17b3c5ae418d82694895a326dee545a ODILIA 12670516743 NULL 12670516743 00124 LUVA CIRURGICA UN 0.0000 1.4500 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 d17b3c5ae418d82694895a326dee545a ODILIA 12670516743 NULL 12670516743 02197 METAMUCIL (PLANTAGO OVATA) 3,4 G PO VO EV 0.0000 2.4600 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 d17b3c5ae418d82694895a326dee545a ODILIA 12670516743 NULL 12670516743 02197 METAMUCIL (PLANTAGO OVATA) 3,4 G PO VO EV 0.0000 2.4600 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 d17b3c5ae418d82694895a326dee545a ODILIA 12670516743 NULL 12670516743 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 102001 DIARIA DE APARTAMENTO 0.0000 288.8882 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4074 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4074 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4074 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 01611 CLORETO DE POTASSIO 600 MG CA VO UN 0.0000 0.4867 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 02246 HIDROCORTISONA 100 MG PO IM IV FA 0.0000 2.8300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 02246 HIDROCORTISONA 100 MG PO IM IV FA 0.0000 2.8300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 02246 HIDROCORTISONA 100 MG PO IM IV FA 0.0000 2.8300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 02246 HIDROCORTISONA 100 MG PO IM IV FA 0.0000 2.8300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 02246 HIDROCORTISONA 100 MG PO IM IV FA 0.0000 2.8300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 26981 SORO FISIOLOGICO 0,9% 10 ML SI IV AP 0.0000 0.4800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 26981 SORO FISIOLOGICO 0,9% 10 ML SI IV AP 0.0000 0.4800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 26981 SORO FISIOLOGICO 0,9% 10 ML SI IV AP 0.0000 0.4800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 26981 SORO FISIOLOGICO 0,9% 10 ML SI IV AP 0.0000 0.4800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 26981 SORO FISIOLOGICO 0,9% 10 ML SI IV AP 0.0000 0.4800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 00404 LACTULOSE 667 MG/ML XP VO ML 0.0000 6.4300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 00404 LACTULOSE 667 MG/ML XP VO ML 0.0000 6.4300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 00404 LACTULOSE 667 MG/ML XP VO ML 0.0000 6.4300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 000451 TAXA DE ALIMENTACAO PARA ACOMPANHANTES - 3 REFEICO 0.0000 0.0000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 00487 RANITIDINA 25 MG/ML 2 ML SI IM IV AP 0.0000 0.9300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1771 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1771 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1771 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1771 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1771 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1771 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1771 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1771 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1771 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1771 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1771 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1771 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1771 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1771 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 081fdadb830fb547e83c43fabdb88372 ELZA 12377335349 NULL 12377335349 51240 FITA ADVANTAGE P/ GLICOSE UN 0.0000 2.5900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 081fdadb830fb547e83c43fabdb88372 ELZA 12377335349 NULL 12377335349 51240 FITA ADVANTAGE P/ GLICOSE UN 0.0000 2.5900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 081fdadb830fb547e83c43fabdb88372 ELZA 12377335349 NULL 12377335349 09071 ACETILCISTEINA 600MG PO VO SA 0.0000 3.5000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 081fdadb830fb547e83c43fabdb88372 ELZA 12377335349 NULL 12377335349 09071 ACETILCISTEINA 600MG PO VO SA 0.0000 3.5000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 081fdadb830fb547e83c43fabdb88372 ELZA 12377335349 NULL 12377335349 09071 ACETILCISTEINA 600MG PO VO SA 0.0000 3.5000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 081fdadb830fb547e83c43fabdb88372 ELZA 12377335349 NULL 12377335349 09071 ACETILCISTEINA 600MG PO VO SA 0.0000 3.5000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 24571 CLINDAMICINA 600 MG 4 ML SI IM IV AP 0.0000 13.0800 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 24571 CLINDAMICINA 600 MG 4 ML SI IM IV AP 0.0000 13.0800 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 24571 CLINDAMICINA 600 MG 4 ML SI IM IV AP 0.0000 13.0800 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 24571 CLINDAMICINA 600 MG 4 ML SI IM IV AP 0.0000 13.0800 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 24571 CLINDAMICINA 600 MG 4 ML SI IM IV AP 0.0000 13.0800 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 24571 CLINDAMICINA 600 MG 4 ML SI IM IV AP 0.0000 13.0800 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 24571 CLINDAMICINA 600 MG 4 ML SI IM IV AP 0.0000 13.0800 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 14191 OMEPRAZOL 20 MG CA VO UN 0.0000 0.9000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 14191 OMEPRAZOL 20 MG CA VO UN 0.0000 0.9000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 35382 COMPRESSAS DE GASES 7.5 X7,5 (11 FIOS ESTERIL) UN 0.0000 0.3000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 00406 FUROSEMIDA 10 MG/ML 2 ML SI IM IV AP 0.0000 0.6000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 00487 RANITIDINA 25 MG/ML 2 ML SI IM IV AP 0.0000 0.9300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.4000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.8100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 51379 SERINGA DESC 05 ML UN 0.0000 0.1900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 51379 SERINGA DESC 05 ML UN 0.0000 0.1900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 51379 SERINGA DESC 05 ML UN 0.0000 0.1900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 51379 SERINGA DESC 05 ML UN 0.0000 0.1900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 51588 ESPARADRAPO MICROPORE 50 X 10 CM CM 0.0000 0.7700 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 00541 AMIODARONA 200 MG CP VO UN 0.0000 0.8400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 06400 CARVEDILOL 3,125 MG CP VO UN 0.0000 0.7300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 102001 DIARIA DE APARTAMENTO 0.0000 288.8900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 00128 LUVA DE PROCEDIMENTO UNIDADE UN 0.0000 1.0000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 51589 ESPARADRAPO 10 X 4.5 CM CM 0.0000 0.4000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 51589 ESPARADRAPO 10 X 4.5 CM CM 0.0000 0.4000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 51649 ALCOOL ETILICO 70 % ST TP ML 0.0000 0.0300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 51649 ALCOOL ETILICO 70 % ST TP ML 0.0000 0.0300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 51649 ALCOOL ETILICO 70 % ST TP ML 0.0000 0.0300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 51649 ALCOOL ETILICO 70 % ST TP ML 0.0000 0.0300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 00090 SERINGA DESC 20 ML UN 0.0000 0.5400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 00090 SERINGA DESC 20 ML UN 0.0000 0.5400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 00090 SERINGA DESC 20 ML UN 0.0000 0.5400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 00919 ALGODAO HIDROFILO BOLINHA UN 0.0000 0.2600 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 00943 EQUIPO POLIFIX 2 VIAS UN 0.0000 2.5500 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 f3ad474c8c562757c4d1a959ff0961c4 DJALMA 12718763240 NULL 12718763240 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 f3ad474c8c562757c4d1a959ff0961c4 DJALMA 12718763240 NULL 12718763240 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 f3ad474c8c562757c4d1a959ff0961c4 DJALMA 12718763240 NULL 12718763240 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 f3ad474c8c562757c4d1a959ff0961c4 DJALMA 12718763240 NULL 12718763240 00037 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 f3ad474c8c562757c4d1a959ff0961c4 DJALMA 12718763240 NULL 12718763240 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 f3ad474c8c562757c4d1a959ff0961c4 DJALMA 12718763240 NULL 12718763240 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 f3ad474c8c562757c4d1a959ff0961c4 DJALMA 12718763240 NULL 12718763240 00904 NORIPURUM EV 20 MG/ML 5 ML SI IV AP 0.0000 18.7700 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 f3ad474c8c562757c4d1a959ff0961c4 DJALMA 12718763240 NULL 12718763240 00090 SERINGA DESC 20 ML UN 0.0000 0.5400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3fb5c891f31bb9efcb05395066127c52 ALAIDE 12636273441 NULL 12636273441 14250 PARACETAMOL 750 MG CP VO UN 0.0000 0.4500 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3fb5c891f31bb9efcb05395066127c52 ALAIDE 12636273441 NULL 12636273441 26981 SORO FISIOLOGICO 0,9% 10 ML SI IV AP 0.0000 0.0000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00090 SERINGA DESC 20 ML UN 0.5400 0.2200 0.3200 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00090 SERINGA DESC 20 ML UN 0.5400 0.2200 0.3200 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00090 SERINGA DESC 20 ML UN 0.5400 0.2200 0.3200 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00090 SERINGA DESC 20 ML UN 0.5400 0.2200 0.3200 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.6900 0.2700 0.4200 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.6900 0.2700 0.4200 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00493 BROMOPRIDA 5 MG/ML 2 ML SI IM IV AP 2.7300 1.0600 1.6700 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00493 BROMOPRIDA 5 MG/ML 2 ML SI IM IV AP 2.7300 1.0600 1.6700 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00493 BROMOPRIDA 5 MG/ML 2 ML SI IM IV AP 2.7300 1.0600 1.6700 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00493 BROMOPRIDA 5 MG/ML 2 ML SI IM IV AP 2.7300 1.0600 1.6700 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00493 BROMOPRIDA 5 MG/ML 2 ML SI IM IV AP 2.7300 1.0600 1.6700 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00124 LUVA CIRURGICA UN 2.9000 1.1300 1.7700 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 51163 AGUA BIDESTILADA 250 ML 5.7900 2.2600 3.5300 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 51163 AGUA BIDESTILADA 250 ML 5.7900 2.2600 3.5300 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 53144 TRAMAL 5.9900 2.3300 3.6600 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 53144 TRAMAL 5.9900 2.3300 3.6600 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 53144 TRAMAL 5.9900 2.3300 3.6600 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00613 CLINDAMICINA 600 MG 4 ML SI IM IV AP 13.0800 5.1000 7.9800 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 16b1e9f62f247f02ad5cac910ee15b4e BERCHOLINA 12631612848 NULL 12631612848 33219 LUVA DE PROCEDIMENTO UNIDADE UN 1.0000 1.1687 -0.1687 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 16b1e9f62f247f02ad5cac910ee15b4e BERCHOLINA 12631612848 NULL 12631612848 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4081 0.0019 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 16b1e9f62f247f02ad5cac910ee15b4e BERCHOLINA 12631612848 NULL 12631612848 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4081 0.0019 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 16b1e9f62f247f02ad5cac910ee15b4e BERCHOLINA 12631612848 NULL 12631612848 19160 SERINGA DESC 20 ML UN 0.5400 0.5385 0.0015 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 16b1e9f62f247f02ad5cac910ee15b4e BERCHOLINA 12631612848 NULL 12631612848 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1900 0.1781 0.0119 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 16b1e9f62f247f02ad5cac910ee15b4e BERCHOLINA 12631612848 NULL 12631612848 33219 LUVA DE PROCEDIMENTO UNIDADE UN 0.8370 1.0018 -0.3318 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 16b1e9f62f247f02ad5cac910ee15b4e BERCHOLINA 12631612848 NULL 12631612848 00090 SERINGA DESC 20 ML UN 0.5400 0.5200 0.0200 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 16b1e9f62f247f02ad5cac910ee15b4e BERCHOLINA 12631612848 NULL 12631612848 00090 SERINGA DESC 20 ML UN 0.5400 0.5200 0.0200 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 16b1e9f62f247f02ad5cac910ee15b4e BERCHOLINA 12631612848 NULL 12631612848 00090 SERINGA DESC 20 ML UN 0.5400 0.5200 0.0200 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 16b1e9f62f247f02ad5cac910ee15b4e BERCHOLINA 12631612848 NULL 12631612848 00406 FUROSEMIDA 10 MG/ML 2 ML SI IM IV AP 1.2000 1.1500 0.0500 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 16b1e9f62f247f02ad5cac910ee15b4e BERCHOLINA 12631612848 NULL 12631612848 00171 SORO FISIOLOGICO 0,9% 250 ML SI IV BS 3.9400 3.7600 0.1800 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 33219 LUVA DE PROCEDIMENTO UNIDADE UN 1.6700 0.0000 1.6700 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 31d18d6607d9e742c53e748d6a55d740 CARLOS 12557779343 NULL 12557779343 37761 ALCOOL ETILICO 70 % ST TP ML 0.0600 0.0300 0.0300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 00817 ALGODAO HIDROFILO BOLINHA UN 0.2600 0.1300 0.1300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 33219 LUVA DE PROCEDIMENTO UNIDADE UN 1.0000 0.6700 0.3300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 53660 EQUIPO MACRO-GOTAS FLEXIVEL C/ INJETOR LATE 1.5900 0.0000 1.5900 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 5f044434edae42d3d17c4392018c7824 DINORA 12673932742 NULL 12673932742 20567 SORO FISIOLOGICO 0,9% 500 ML SI IV BS 4.7300 0.0000 4.7300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 d4089ccef13567fd45b16fb0b60685fa VERA 12656425943 NULL 12656425943 33219 LUVA DE PROCEDIMENTO UNIDADE UN 1.6700 0.6700 1.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 edffb7fef608512400078fdf75991573 CARLA 12728631049 NULL 12728631049 19216 SEVOFLURANO 1 ML/ML (100%) SL IN ML 301.8000 176.0500 125.7500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd6f8d6c53ffe9bfd3aa9590ba500cc8 ILDA 12751932542 NULL 12751932542 33219 LUVA DE PROCEDIMENTO UNIDADE UN 3.3300 1.6700 1.6600 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 37761 ALCOOL ETILICO 70 % ST TP ML 0.0600 0.0300 0.0300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 33219 LUVA DE PROCEDIMENTO UNIDADE UN 1.0000 0.6700 0.3300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 33219 LUVA DE PROCEDIMENTO UNIDADE UN 1.0000 0.6700 0.3300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 33219 LUVA DE PROCEDIMENTO UNIDADE UN 1.0000 0.6700 0.3300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 12750 LAMINA BISTURI N 10, 11,12 E 15 UN 2.2000 1.1000 1.1000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 19160 SERINGA DESC 20 ML UN 0.5400 0.0000 0.5400 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 00817 ALGODAO HIDROFILO BOLINHA UN 0.5100 0.2600 0.2500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cd2840524be5a3f1d0939f241e24f32b MARIA 12705908340 NULL 12705908340 33219 LUVA DE PROCEDIMENTO UNIDADE UN 1.0000 0.6700 0.3300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cd2840524be5a3f1d0939f241e24f32b MARIA 12705908340 NULL 12705908340 00817 ALGODAO HIDROFILO BOLINHA UN 0.2600 0.1300 0.1300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cd2840524be5a3f1d0939f241e24f32b MARIA 12705908340 NULL 12705908340 37761 ALCOOL ETILICO 70 % ST TP ML 0.0300 0.0200 0.0100 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cd2840524be5a3f1d0939f241e24f32b MARIA 12705908340 NULL 12705908340 33219 LUVA DE PROCEDIMENTO UNIDADE UN 1.0000 0.6700 0.3300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cd2840524be5a3f1d0939f241e24f32b MARIA 12705908340 NULL 12705908340 30376 BROMETO DE IPRATROPIO 0,25MG/ML SL IN GT 1.2000 0.0000 1.2000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12603877940 NULL 12603877940 11134 HEPARINA 5000 UI/ML 5 ML SI IV SC ML 2.8800 0.7200 2.1600 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12603877940 NULL 12603877940 30651 CIPROFLOXACINO 2 MG/ML 100 ML SI IV BS 80.1700 0.0000 80.1700 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12603877940 NULL 12603877940 37761 ALCOOL ETILICO 70 % ST TP ML 0.0300 0.0200 0.0100 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12603877940 NULL 12603877940 19151 SERINGA DESC 10 ML UN 2.0000 0.0000 2.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12603877940 NULL 12603877940 55018 ALGINATO DE CALCIO EM HIDROGEL GL TP GR 20.7000 13.8000 6.9000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 08648 ESPARADRAPO 10 X 4.5 CM CM 0.4000 0.2000 0.2000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 02461 FENOTEROL 2 MG/ML 10 ML AE IN DS 2.5500 0.0000 2.5500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 d4089ccef13567fd45b16fb0b60685fa VERA 12656425943 NULL 12656425943 25040014 ASSISTENCIA FISIATRICA RESPIRATORIA 0.0000 5.0300 NULL ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 818a6f2e549cc6a60aa20f9d0595eec9 ANTONIO 12565134343 NULL 12565134343 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1767 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 a050ed50115d2a6dd0b15b99b39063da ARI 12676101147 NULL 12676101147 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1750 0.0050 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 a050ed50115d2a6dd0b15b99b39063da ARI 12676101147 NULL 12676101147 19160 SERINGA DESC 20 ML UN 0.5400 0.5367 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 edffb7fef608512400078fdf75991573 CARLA 12728631049 NULL 12728631049 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1760 0.0040 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 edffb7fef608512400078fdf75991573 CARLA 12728631049 NULL 12728631049 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1760 0.0040 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 39df67956a358bf1eab89803158d25dd HELENA 12655863342 NULL 12655863342 08664 ESPARADRAPO MICROPORE 50 X 10 CM CM 0.7700 0.7600 0.0000 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 39df67956a358bf1eab89803158d25dd HELENA 12655863342 NULL 12655863342 33219 LUVA DE PROCEDIMENTO UNIDADE UN 1.6700 1.6647 0.0053 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 cb57fc8e673b7c8bc339e1fe25d70cd5 HELIO 12661165148 NULL 12661165148 07269 DIPIRONA 500 MG/ML 2 ML SI IV IM AP 0.6900 0.6867 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 9d06dbe3a8516628c3a045963dfb9c42 INAN 12623574546 NULL 12623574546 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1757 0.0043 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 4668d2494ed6c4b2d18be299efcb26a2 JOAO 12469689344 NULL 12469689344 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1700 0.0000 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 4668d2494ed6c4b2d18be299efcb26a2 JOAO 12469689344 NULL 12469689344 07269 DIPIRONA 500 MG/ML 2 ML SI IV IM AP 2.7500 2.7400 0.0000 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 4668d2494ed6c4b2d18be299efcb26a2 JOAO 12469689344 NULL 12469689344 17817 PROLOPA (LEVODOPA 200 MG + BENSERAZIDA 50 M 2.1200 2.1150 0.0050 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 d4089ccef13567fd45b16fb0b60685fa VERA 12640482546 NULL 12640482546 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1754 0.0046 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 01081197 5b1e846d62341272eec7cc65f2fed2e7 ANGELIA 12734669220 NULL 12734669220 32050038 TORAX PA 0.0000 11.0271 NULL ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 000501 OXIGENIO 0.0000 1023.0000 NULL ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 25030019 DISTURBIOS CIRCULATORIOS ARTERIO VE 0.0000 126.1000 NULL ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 cd8240dfed3b190f93e1f35f15f53916 WANDELCY 12756680448 NULL 12756680448 25030019 DISTURBIOS CIRCULATORIOS ARTERIO VE 0.0000 0.0000 NULL ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 de1a8276d878171456d7fc8f6dcd2457 ABEL 12764206443 NULL 12764206443 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8067 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 de1a8276d878171456d7fc8f6dcd2457 ABEL 12764206443 NULL 12764206443 07269 DIPIRONA 500 MG/ML 2 ML SI IV IM AP 0.6900 0.6867 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 de1a8276d878171456d7fc8f6dcd2457 ABEL 12764206443 NULL 12764206443 07269 DIPIRONA 500 MG/ML 2 ML SI IV IM AP 0.6900 0.6860 0.0040 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 31585 RANITIDINA 25 MG/ML 2 ML SI IV IM AP 1.8700 1.8667 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1780 0.0020 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1770 0.0030 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1770 0.0030 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1770 0.0030 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1770 0.0030 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1770 0.0030 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1770 0.0030 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1770 0.0030 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8072 0.0028 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 09733 ACETILCISTEINA 600MG PO VO SA 3.5000 3.4955 0.0045 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 09733 ACETILCISTEINA 600MG PO VO SA 3.5000 3.4955 0.0045 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 09733 ACETILCISTEINA 600MG PO VO SA 3.5000 3.4955 0.0045 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 09733 ACETILCISTEINA 600MG PO VO SA 3.5000 3.4955 0.0045 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 08664 ESPARADRAPO MICROPORE 50 X 10 CM CM 0.2600 0.2561 0.0039 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 08664 ESPARADRAPO MICROPORE 50 X 10 CM CM 0.7700 0.7682 0.0018 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 42358 FUROSEMIDA 10 MG/ML 2 ML SI IM IV AP 0.6000 0.5984 0.0016 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4078 0.0022 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4078 0.0022 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4078 0.0022 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4078 0.0022 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4078 0.0022 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4078 0.0022 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4078 0.0022 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4078 0.0022 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 33227 LUVA CIRURGICA PAR UN 1.4500 1.4492 0.0008 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 33227 LUVA CIRURGICA PAR UN 1.4500 1.4476 0.0024 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 33227 LUVA CIRURGICA PAR UN 1.4500 1.4476 0.0024 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1038 -0.0038 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1038 -0.0038 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1038 -0.0038 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1038 -0.0038 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 b288bbcfb9aecab51bcb0dba62ca0059 IVONETE 12743730847 NULL 12743730847 19160 SERINGA DESC 20 ML UN 0.5400 0.5367 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 b288bbcfb9aecab51bcb0dba62ca0059 IVONETE 12743730847 NULL 12743730847 19160 SERINGA DESC 20 ML UN 0.5400 0.5367 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1900 0.1900 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1800 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 00817 ALGODAO HIDROFILO BOLINHA UN 0.2600 0.1300 0.1300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4084 0.0016 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4084 0.0016 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4084 0.0016 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4084 0.0016 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4084 0.0016 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1036 -0.0036 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1036 -0.0036 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 2a79bf9d53875b480086bd7b8321c4f1 JOSE 12641066643 NULL 12641066643 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1700 0.0000 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 2a79bf9d53875b480086bd7b8321c4f1 JOSE 12641066643 NULL 12641066643 12262 ISOSSORBIDA 20 MG CP VO UN 0.2200 0.2167 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 19160 SERINGA DESC 20 ML UN 0.5400 0.5384 0.0016 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 19160 SERINGA DESC 20 ML UN 0.5400 0.5384 0.0016 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 19160 SERINGA DESC 20 ML UN 0.5400 0.5384 0.0016 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 19160 SERINGA DESC 20 ML UN 0.5400 0.5384 0.0016 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 19160 SERINGA DESC 20 ML UN 0.5400 0.5384 0.0016 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 32204 CLORETO DE SODIO 0,9% 10 ML SI IV AP 0.4800 0.0000 0.4800 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 32204 CLORETO DE SODIO 0,9% 10 ML SI IV AP 0.4800 0.0000 0.4800 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 32204 CLORETO DE SODIO 0,9% 10 ML SI IV AP 0.4800 0.0000 0.4800 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 30376 BROMETO DE IPRATROPIO 0,25MG/ML SL IN GT 0.6000 0.0000 0.6000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8067 0.0033 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8067 0.0033 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8067 0.0033 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 33219 LUVA DE PROCEDIMENTO UNIDADE UN 0.6700 0.0000 0.6700 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 33219 LUVA DE PROCEDIMENTO UNIDADE UN 1.0000 0.6700 0.3300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 32204 CLORETO DE SODIO 0,9% 10 ML SI IV AP 0.4800 0.0000 0.4800 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 53660 EQUIPO MACRO-GOTAS FLEXIVEL C/ INJETOR LATE 1.5900 0.0000 1.5900 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 14460 DOMPERIDONA 10 MG CP VO UN 0.3900 0.0000 0.3900 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 14460 DOMPERIDONA 10 MG CP VO UN 0.3900 0.0000 0.3900 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 32204 CLORETO DE SODIO 0,9% 10 ML SI IV AP 0.4800 0.0000 0.4800 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 32204 CLORETO DE SODIO 0,9% 10 ML SI IV AP 0.4800 0.0000 0.4800 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 32204 CLORETO DE SODIO 0,9% 10 ML SI IV AP 0.4800 0.0000 0.4800 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e715e2ae28a6229c8609756d3298bf52 MARIA 12734221144 NULL 12734221144 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1750 0.0050 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 11193 CLOREXIDINA 2 % ST TP ML 0.2700 0.2650 0.0050 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 05975 COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER 0.3000 0.0000 0.3000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 05975 COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER 0.3000 0.3833 -0.0833 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 05975 COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER 0.3000 0.0000 0.3000 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 33537 PIPERACILINA 2 G + TAZOBACTAM 250 MG 30 ML 55.3400 55.3375 0.0025 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 33537 PIPERACILINA 2 G + TAZOBACTAM 250 MG 30 ML 55.3400 55.3375 0.0025 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 42358 FUROSEMIDA 10 MG/ML 2 ML SI IM IV AP 1.2000 1.1964 0.0036 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 42358 FUROSEMIDA 10 MG/ML 2 ML SI IM IV AP 1.2000 1.1964 0.0036 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 42358 FUROSEMIDA 10 MG/ML 2 ML SI IM IV AP 1.2000 1.1964 0.0036 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4061 0.0039 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4061 0.0039 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 33227 LUVA CIRURGICA PAR UN 1.4500 1.4477 0.0023 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 33227 LUVA CIRURGICA PAR UN 1.4500 1.4477 0.0023 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 33227 LUVA CIRURGICA PAR UN 1.4500 1.4477 0.0023 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 19135 SERINGA DESC 03 ML UN 0.1500 0.0000 0.1500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 19135 SERINGA DESC 03 ML UN 0.1500 0.0000 0.1500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 08664 ESPARADRAPO MICROPORE 50 X 10 CM CM 0.7700 0.0000 0.7700 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 19135 SERINGA DESC 03 ML UN 0.1500 0.0000 0.1500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 19151 SERINGA DESC 10 ML UN 0.6700 0.6657 0.0043 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.2100 0.2057 0.0043 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1772 0.0028 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1772 0.0028 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1772 0.0028 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 08664 ESPARADRAPO MICROPORE 50 X 10 CM CM 0.7700 0.7670 0.0030 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cd2840524be5a3f1d0939f241e24f32b MARIA 12705908340 NULL 12705908340 32204 CLORETO DE SODIO 0,9% 10 ML SI IV AP 0.4800 0.0000 0.4800 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cd2840524be5a3f1d0939f241e24f32b MARIA 12705908340 NULL 12705908340 32204 CLORETO DE SODIO 0,9% 10 ML SI IV AP 0.4800 0.4800 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cd2840524be5a3f1d0939f241e24f32b MARIA 12705908340 NULL 12705908340 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1764 0.0036 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 a6786839bc6f6afb2125c1877c91c932 MARIA 12742515845 NULL 12742515845 102001 DIARIA DE APARTAMENTO SIMPLES 288.8900 288.8800 0.0000 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 d17b3c5ae418d82694895a326dee545a ODILIA 12670516743 NULL 12670516743 30376 BROMETO DE IPRATROPIO 0,25MG/ML SL IN GT 0.4000 0.0000 0.4000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 d17b3c5ae418d82694895a326dee545a ODILIA 12670516743 NULL 12670516743 32204 CLORETO DE SODIO 0,9% 10 ML SI IV AP 0.4800 0.0000 0.4800 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1766 0.0034 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1766 0.0034 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1766 0.0034 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1766 0.0034 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1766 0.0034 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1766 0.0034 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1766 0.0034 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 8a5ecfde671848d05ac757e0112e689c TEREZINHA 12700337042 NULL 12700337042 10626 GLICOSE 50% 10 ML SI IV AP 2.7400 2.7350 0.0050 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 8a5ecfde671848d05ac757e0112e689c TEREZINHA 12700337042 NULL 12700337042 10626 GLICOSE 50% 10 ML SI IV AP 2.7400 2.7350 0.0050 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 8a5ecfde671848d05ac757e0112e689c TEREZINHA 12700337042 NULL 12700337042 10626 GLICOSE 50% 10 ML SI IV AP 2.7400 2.7350 0.0050 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 8a5ecfde671848d05ac757e0112e689c TEREZINHA 12700337042 NULL 12700337042 57258 FUMARATO DE QUETIAPINA 25 MG CA VO UN 1.2500 1.2450 0.0050 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 8a5ecfde671848d05ac757e0112e689c TEREZINHA 12700337042 NULL 12700337042 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4071 0.0029 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 8a5ecfde671848d05ac757e0112e689c TEREZINHA 12700337042 NULL 12700337042 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4071 0.0029 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 8a5ecfde671848d05ac757e0112e689c TEREZINHA 12700337042 NULL 12700337042 19160 SERINGA DESC 20 ML UN 0.5400 0.5376 0.0024 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 8a5ecfde671848d05ac757e0112e689c TEREZINHA 12700337042 NULL 12700337042 19160 SERINGA DESC 20 ML UN 0.5400 0.5376 0.0024 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 70cf23c63f890f0b61da2542c3e13a09 TIAGO 12741864645 NULL 12741864645 50385 CETOPROFENO 100 MG PO IV FA 7.7800 7.7700 0.0000 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 70cf23c63f890f0b61da2542c3e13a09 TIAGO 12741864645 NULL 12741864645 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1762 0.0038 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 70cf23c63f890f0b61da2542c3e13a09 TIAGO 12741864645 NULL 12741864645 19160 SERINGA DESC 20 ML UN 0.5400 0.5367 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 70cf23c63f890f0b61da2542c3e13a09 TIAGO 12741864645 NULL 12741864645 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4075 0.0025 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 70cf23c63f890f0b61da2542c3e13a09 TIAGO 12741864645 NULL 12741864645 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4075 0.0025 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 32204 CLORETO DE SODIO 0,9% 10 ML SI IV AP 0.9600 0.9600 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 08648 ESPARADRAPO 10 X 4.5 CM CM 0.4000 0.4000 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 0111beed375944f60c7ad4a7fd4874f8 WALDIR 12746025744 NULL 12746025744 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8074 0.0026 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 0111beed375944f60c7ad4a7fd4874f8 WALDIR 12746025744 NULL 12746025744 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 1.6200 1.6147 0.0053 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 0111beed375944f60c7ad4a7fd4874f8 WALDIR 12746025744 NULL 12746025744 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4076 0.0024 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 0111beed375944f60c7ad4a7fd4874f8 WALDIR 12746025744 NULL 12746025744 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4076 0.0024 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 0111beed375944f60c7ad4a7fd4874f8 WALDIR 12746025744 NULL 12746025744 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4076 0.0024 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 0111beed375944f60c7ad4a7fd4874f8 WALDIR 12746025744 NULL 12746025744 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4076 0.0024 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 0111beed375944f60c7ad4a7fd4874f8 WALDIR 12746025744 NULL 12746025744 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4076 0.0024 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 0111beed375944f60c7ad4a7fd4874f8 WALDIR 12746025744 NULL 12746025744 19160 SERINGA DESC 20 ML UN 0.5400 0.5379 0.0021 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 0111beed375944f60c7ad4a7fd4874f8 WALDIR 12746025744 NULL 12746025744 19160 SERINGA DESC 20 ML UN 0.5400 0.5379 0.0021 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 0111beed375944f60c7ad4a7fd4874f8 WALDIR 12746025744 NULL 12746025744 19160 SERINGA DESC 20 ML UN 0.5400 0.5379 0.0021 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 0111beed375944f60c7ad4a7fd4874f8 WALDIR 12746025744 NULL 12746025744 19160 SERINGA DESC 20 ML UN 0.5400 0.5379 0.0021 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 27596 TIRA TESTE PARA GLICOSE UN 1.0400 1.0400 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 27596 TIRA TESTE PARA GLICOSE UN 1.0400 1.0400 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 27596 TIRA TESTE PARA GLICOSE UN 1.0400 1.0400 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 05975 COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER 0.3000 0.0000 0.3000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12647284040 NULL 12647284040 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4086 0.0014 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12647284040 NULL 12647284040 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4086 0.0014 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12647284040 NULL 12647284040 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4086 0.0014 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12662414945 NULL 12662414945 19445 CLORETO DE POTASSIO 600 MG CA VO UN 0.4900 0.4864 0.0036 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12662414945 NULL 12662414945 42358 FUROSEMIDA 10 MG/ML 2 ML SI IM IV AP 1.2000 1.1967 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12662414945 NULL 12662414945 42358 FUROSEMIDA 10 MG/ML 2 ML SI IM IV AP 1.2000 1.1967 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12662414945 NULL 12662414945 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4071 0.0029 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12662414945 NULL 12662414945 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4071 0.0029 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 05975 COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER 0.6000 0.6000 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 05975 COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER 0.6000 0.6000 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 05975 COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER 0.3000 0.0000 0.3000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 05975 COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER 0.3000 0.1500 0.1500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 19160 SERINGA DESC 20 ML UN 1.0800 1.0733 0.0067 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 33227 LUVA CIRURGICA PAR UN 1.4500 1.4476 0.0024 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 33227 LUVA CIRURGICA PAR UN 1.4500 1.4476 0.0024 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 33227 LUVA CIRURGICA PAR UN 1.4500 1.4476 0.0024 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 33227 LUVA CIRURGICA PAR UN 1.4500 1.4476 0.0024 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 33227 LUVA CIRURGICA PAR UN 1.4500 1.4476 0.0024 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 33227 LUVA CIRURGICA PAR UN 1.4500 1.4476 0.0024 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 08435 EQUIPO P/ BOMBA DE INFUSAO ENTERAL / PARENT 20.2800 20.2800 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 33219 LUVA DE PROCEDIMENTO UNIDADE UN 0.3300 0.0000 0.3300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1770 0.0030 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1770 0.0030 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN NULL 0.0000 NULL OPME INVALIDO 2201
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 00172 SORO FISIOLOGICO 0,9% 500 ML SI IV BS NULL 0.0000 NULL OPME INVALIDO 2201
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 34789 SONDA ASPIRAÇAO C/ VALVULA - TODAS - UTI UN 0.9400 0.9367 0.0033 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 34789 SONDA ASPIRAÇAO C/ VALVULA - TODAS - UTI UN 0.9400 0.9367 0.0033 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 33219 LUVA DE PROCEDIMENTO UNIDADE UN 1.0000 0.6700 0.3300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 37761 ALCOOL ETILICO 70 % ST TP ML 0.0300 0.0000 0.0300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00817 ALGODAO HIDROFILO BOLINHA UN 0.2600 0.1300 0.1300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 07269 DIPIRONA 500 MG/ML 2 ML SI IV IM AP 0.6900 0.0000 0.6900 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.2120 -0.1120 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.2120 -0.1120 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.2120 -0.1120 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.2120 -0.1120 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1060 -0.0060 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1060 -0.0060 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1060 -0.0060 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1060 -0.0060 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1060 -0.0060 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1060 -0.0060 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1060 -0.0060 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1060 -0.0060 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 34827 TIORFAN (RACECADOTRILA) 100 MG CA VO UN 3.2000 6.4000 -3.2000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 34827 TIORFAN (RACECADOTRILA) 100 MG CA VO UN 3.2000 6.4000 -3.2000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 34827 TIORFAN (RACECADOTRILA) 100 MG CA VO UN 3.2000 6.4000 -3.2000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 34827 TIORFAN (RACECADOTRILA) 100 MG CA VO UN 3.2000 3.2000 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 27596 TIRA TESTE PARA GLICOSE UN 1.0400 2.0800 -1.0400 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 19160 SERINGA DESC 20 ML UN 0.5400 0.5386 0.0014 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 19160 SERINGA DESC 20 ML UN 0.5400 0.5374 0.0026 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 19160 SERINGA DESC 20 ML UN 0.5400 0.5374 0.0026 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 31585 RANITIDINA 25 MG/ML 2 ML SI IV IM AP 0.9300 1.8676 -0.9376 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 31585 RANITIDINA 25 MG/ML 2 ML SI IV IM AP 0.9300 1.8668 -0.9368 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 31585 RANITIDINA 25 MG/ML 2 ML SI IV IM AP 0.9300 1.8668 -0.9368 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 31585 RANITIDINA 25 MG/ML 2 ML SI IV IM AP 0.9300 0.9334 -0.0034 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 31585 RANITIDINA 25 MG/ML 2 ML SI IV IM AP 0.9300 0.9334 -0.0034 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 31585 RANITIDINA 25 MG/ML 2 ML SI IV IM AP 0.9300 0.9334 -0.0034 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 19151 SERINGA DESC 10 ML UN 0.6634 0.9985 -0.6685 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 19151 SERINGA DESC 10 ML UN 0.6634 1.0003 -0.6703 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 19151 SERINGA DESC 10 ML UN 0.6634 1.0003 -0.6703 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 19151 SERINGA DESC 10 ML UN 0.6634 1.0003 -0.6703 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 19151 SERINGA DESC 10 ML UN 0.6634 1.0003 -0.6703 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 19151 SERINGA DESC 10 ML UN 0.3300 0.6669 -0.3369 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 19151 SERINGA DESC 10 ML UN 0.3300 0.6669 -0.3369 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 19151 SERINGA DESC 10 ML UN 0.3300 0.6669 -0.3369 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 19151 SERINGA DESC 10 ML UN 0.3300 0.6669 -0.3369 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 19151 SERINGA DESC 10 ML UN 0.3300 0.6669 -0.3369 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 19151 SERINGA DESC 10 ML UN 0.3300 0.6669 -0.3369 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 37761 ALCOOL ETILICO 70 % ST TP ML 0.0631 0.0695 -0.0395 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 21822 TRAMADOL 50 MG 1 ML SI IM IV AP 25.1571 29.3540 -25.1640 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 21822 TRAMADOL 50 MG 1 ML SI IM IV AP 25.1571 29.3540 -25.1640 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 11193 CLOREXIDINA 2 % ST TP ML 0.5300 0.5320 -0.0020 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 11193 CLOREXIDINA 2 % ST TP ML 0.5300 0.5320 -0.0020 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 05975 COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER 0.7739 0.8059 -0.7759 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 05975 COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER 0.7739 0.8059 -0.7759 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 05975 COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER 0.7739 0.8059 -0.7759 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 800720d33fe0defb6121e82dd216d044 JALMO 12786952647 NULL 12786952647 00124 LUVA CIRURGICA UN 0.0000 1.4500 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 800720d33fe0defb6121e82dd216d044 JALMO 12786952647 NULL 12786952647 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 800720d33fe0defb6121e82dd216d044 JALMO 12786952647 NULL 12786952647 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00171 SORO FISIOLOGICO 0,9% 250 ML SI IV BS 0.0000 3.9400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00172 SORO FISIOLOGICO 0,9% 500 ML SI IV BS 0.0000 4.7300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 02246 HIDROCORTISONA 100 MG PO IM IV FA 0.0000 2.8300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 02246 HIDROCORTISONA 100 MG PO IM IV FA 0.0000 2.8300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 25030019 Distúrbios Circulatórios Artério - Venosos e Linfáticos 0.0000 80.2400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 26981 SORO FISIOLOGICO 0,9% 10 ML SI IV AP 0.0000 0.0000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 26981 SORO FISIOLOGICO 0,9% 10 ML SI IV AP 0.0000 0.0000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 26981 SORO FISIOLOGICO 0,9% 10 ML SI IV AP 0.0000 0.0000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 26981 SORO FISIOLOGICO 0,9% 10 ML SI IV AP 0.0000 0.0000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 26981 SORO FISIOLOGICO 0,9% 10 ML SI IV AP 0.0000 0.9600 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00613 CLINDAMICINA 600 MG 4 ML SI IM IV AP 0.0000 13.0800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00613 CLINDAMICINA 600 MG 4 ML SI IM IV AP 0.0000 13.0800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00069 SERINGA DESC 10 ML UN 0.0000 0.0000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00069 SERINGA DESC 10 ML UN 0.0000 0.0000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 07802 PIPERACILINA 4 G + TAZOBACTAM 500 MG PO IV FA 0.0000 0.0000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00796 FLORATIL (SACCHAROMYCES BOULARDII) 200 MG PO VO 0.0000 4.4400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 09071 ACETILCISTEINA 600MG PO VO SA 0.0000 3.4950 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 09071 ACETILCISTEINA 600MG PO VO SA 0.0000 3.4950 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00090 SERINGA DESC 20 ML UN 0.0000 0.0000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00124 LUVA CIRURGICA UN 0.0000 1.4475 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00124 LUVA CIRURGICA UN 0.0000 1.4475 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00124 LUVA CIRURGICA UN 0.0000 1.4475 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4062 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4062 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4062 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4062 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4062 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4062 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4062 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4062 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4062 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4062 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 01584 NEOSTIGMINA 0,5 MG/ML 1 ML SI IM IV SC AP 0.0000 0.7667 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 01584 NEOSTIGMINA 0,5 MG/ML 1 ML SI IM IV SC AP 0.0000 0.7667 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 01584 NEOSTIGMINA 0,5 MG/ML 1 ML SI IM IV SC AP 0.0000 0.7667 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 01584 NEOSTIGMINA 0,5 MG/ML 1 ML SI IM IV SC AP 0.0000 0.7667 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 01584 NEOSTIGMINA 0,5 MG/ML 1 ML SI IM IV SC AP 0.0000 0.7667 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 01584 NEOSTIGMINA 0,5 MG/ML 1 ML SI IM IV SC AP 0.0000 0.7667 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 24082 BROMOPRIDA 5 MG/ML 2 ML SI IM IV AP 0.0000 2.7300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00796 FLORATIL (SACCHAROMYCES BOULARDII) 200 MG PO VO 0.0000 4.4400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4088 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4088 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4088 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4088 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1766 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1766 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1766 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1766 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1766 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00090 SERINGA DESC 20 ML UN 0.0000 0.5387 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00090 SERINGA DESC 20 ML UN 0.0000 0.5387 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00090 SERINGA DESC 20 ML UN 0.0000 0.5387 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00090 SERINGA DESC 20 ML UN 0.0000 0.5387 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00090 SERINGA DESC 20 ML UN 0.0000 0.5387 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00090 SERINGA DESC 20 ML UN 0.0000 0.5387 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00090 SERINGA DESC 20 ML UN 0.0000 0.5387 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00090 SERINGA DESC 20 ML UN 0.0000 0.5387 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00090 SERINGA DESC 20 ML UN 0.0000 0.5387 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00090 SERINGA DESC 20 ML UN 0.0000 0.5387 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00090 SERINGA DESC 20 ML UN 0.0000 0.5387 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00090 SERINGA DESC 20 ML UN 0.0000 0.5387 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00090 SERINGA DESC 20 ML UN 0.0000 0.5387 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 4c68006246c347121db1f06edf5e5051 MARIA 12734155245 NULL 12734155245 55050042 Mediastinoscopia e Biópsia 0.0000 0.0400 NULL COBRANCA DE HONORARIOS EM DUPLICIDADE 2607
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 00124 LUVA CIRURGICA UN 0.0000 1.4500 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4074 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 01611 CLORETO DE POTASSIO 600 MG CA VO UN 0.0000 0.4864 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 01611 CLORETO DE POTASSIO 600 MG CA VO UN 0.0000 0.4867 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 02246 HIDROCORTISONA 100 MG PO IM IV FA 0.0000 5.6697 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 25040014 Fisioterapia Respiratória - em Doente Clínico Internado 0.0000 5.0300 NULL EXAME NAO AUTORIZADO 2707
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 29020166 Nebulização Simples com Broncodilatador 0.0000 1.1700 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.8100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.8089 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1775 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1775 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1775 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1775 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1775 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1775 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1775 NULL VALOR APRESENTADO A MAIOR 1705
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1775 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1775 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 00090 SERINGA DESC 20 ML UN 0.0000 0.5376 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 00090 SERINGA DESC 20 ML UN 0.0000 1.0752 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 00124 LUVA CIRURGICA UN 0.0000 1.4476 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 25040014 Fisioterapia Respiratória - em Doente Clínico Internado 0.0000 10.0600 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 35382 COMPRESSAS DE GASES 7.5 X7,5 (11 FIOS ESTERIL) UN 0.0000 0.3000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 51499 CAPTOPRIL 50 MG CP VO UN 0.0000 0.1352 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12579183644 NULL 12579183644 51584 ESPARADRAPO MICROPORE 0.0000 0.2600 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 00124 LUVA CIRURGICA UN 0.0000 1.4482 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 00124 LUVA CIRURGICA UN 0.0000 1.4482 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 00124 LUVA CIRURGICA UN 0.0000 1.4482 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 00124 LUVA CIRURGICA UN 0.0000 1.4500 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 00124 LUVA CIRURGICA UN 0.0000 1.4482 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 00124 LUVA CIRURGICA UN 0.0000 1.4482 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 00124 LUVA CIRURGICA UN 0.0000 1.4500 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 00124 LUVA CIRURGICA UN 0.0000 1.4500 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 00128 LUVA DE PROCEDIMENTO UNIDADE UN 0.0000 1.6700 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.4000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1752 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1752 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1752 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1752 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1752 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 51241 AGULHA 123X45 0.0000 0.1900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 51241 AGULHA 123X45 0.0000 0.1900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 51241 AGULHA 123X45 0.0000 0.1900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 51241 AGULHA 123X45 0.0000 0.1900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 51241 AGULHA 123X45 0.0000 0.1900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 51590 ABAIXADOR DE LINGUA UN 0.0000 0.0500 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 51590 ABAIXADOR DE LINGUA UN 0.0000 0.0500 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 51590 ABAIXADOR DE LINGUA UN 0.0000 0.0500 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 51649 ALCOOL ETILICO 70 % ST TP ML 0.0000 0.0000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 52392 SONDA DE ASPIRAÇAO TRAQUEAL C/ VALVULA UN 0.0000 0.9352 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 52392 SONDA DE ASPIRAÇAO TRAQUEAL C/ VALVULA UN 0.0000 0.9352 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 52392 SONDA DE ASPIRAÇAO TRAQUEAL C/ VALVULA UN 0.0000 0.9352 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 52392 SONDA DE ASPIRAÇAO TRAQUEAL C/ VALVULA UN 0.0000 0.9352 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 52392 SONDA DE ASPIRAÇAO TRAQUEAL C/ VALVULA UN 0.0000 0.9352 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6874 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6874 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6874 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.4000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1775 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.3500 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 53945 ACIDO ASCORBICO 500 MG CP VO UN 0.0000 0.5900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00128 LUVA DE PROCEDIMENTO UNIDADE UN 0.0000 1.6700 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 01496 FENITOINA 50 MG/ML 5 ML SI IM IV AP 0.0000 2.3400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 01496 FENITOINA 50 MG/ML 5 ML SI IM IV AP 0.0000 2.3400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 01584 NEOSTIGMINA 0,5 MG/ML 1 ML SI IM IV SC AP 0.0000 0.7662 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 24082 BROMOPRIDA 5 MG/ML 2 ML SI IM IV AP 0.0000 2.7300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 26981 SORO FISIOLOGICO 0,9% 10 ML SI IV AP 0.0000 0.9600 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 26981 SORO FISIOLOGICO 0,9% 10 ML SI IV AP 0.0000 0.9600 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ea4ad2636c25d8e3dbb569ae62db71e7 IONE 12489788840 NULL 12489788840 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.4000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ea4ad2636c25d8e3dbb569ae62db71e7 IONE 12489788840 NULL 12489788840 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ea4ad2636c25d8e3dbb569ae62db71e7 IONE 12489788840 NULL 12489788840 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ea4ad2636c25d8e3dbb569ae62db71e7 IONE 12489788840 NULL 12489788840 00737 CEFTRIAXONA IV 1G + DIL. 10 ML PO IV FA 0.0000 27.0600 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ea4ad2636c25d8e3dbb569ae62db71e7 IONE 12489788840 NULL 12489788840 00737 CEFTRIAXONA IV 1G + DIL. 10 ML PO IV FA 0.0000 27.0600 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 d17b3c5ae418d82694895a326dee545a ODILIA 12670516743 NULL 12670516743 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 d17b3c5ae418d82694895a326dee545a ODILIA 12670516743 NULL 12670516743 17252 LIDOCAINA 2% GE OU TP GR 0.0000 2.5900 NULL OPME INVALIDO 2201
Glosa Min 2018-10-03 00:00:00.000000 1084117 d17b3c5ae418d82694895a326dee545a ODILIA 12670516743 NULL 12670516743 17252 LIDOCAINA 2% GE OU TP GR 0.0000 2.5900 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 d17b3c5ae418d82694895a326dee545a ODILIA 12670516743 NULL 12670516743 17252 LIDOCAINA 2% GE OU TP GR 0.0000 1.3000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 d17b3c5ae418d82694895a326dee545a ODILIA 12670516743 NULL 12670516743 02197 METAMUCIL (PLANTAGO OVATA) 3,4 G PO VO EV 0.0000 2.4600 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 d17b3c5ae418d82694895a326dee545a ODILIA 12670516743 NULL 12670516743 02197 METAMUCIL (PLANTAGO OVATA) 3,4 G PO VO EV 0.0000 2.4600 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 d17b3c5ae418d82694895a326dee545a ODILIA 12670516743 NULL 12670516743 02197 METAMUCIL (PLANTAGO OVATA) 3,4 G PO VO EV 0.0000 2.4600 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 d17b3c5ae418d82694895a326dee545a ODILIA 12670516743 NULL 12670516743 25040014 Fisioterapia Respiratória - em Doente Clínico Internado 0.0000 0.0000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 d17b3c5ae418d82694895a326dee545a ODILIA 12670516743 NULL 12670516743 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 d17b3c5ae418d82694895a326dee545a ODILIA 12670516743 NULL 12670516743 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 d17b3c5ae418d82694895a326dee545a ODILIA 12670516743 NULL 12670516743 56261 CLOREXIDINA 2 % ST TP ML DEGERMANTE 0.0000 0.2650 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 d17b3c5ae418d82694895a326dee545a ODILIA 12670516743 NULL 12670516743 56261 CLOREXIDINA 2 % ST TP ML DEGERMANTE 0.0000 0.2650 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 102001 DIARIA DE APARTAMENTO 0.0000 288.8882 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 102001 DIARIA DE APARTAMENTO 0.0000 288.8882 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 102001 DIARIA DE APARTAMENTO 0.0000 288.8882 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4074 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4074 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4074 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4072 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 02246 HIDROCORTISONA 100 MG PO IM IV FA 0.0000 2.8300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 02246 HIDROCORTISONA 100 MG PO IM IV FA 0.0000 2.8300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 26981 SORO FISIOLOGICO 0,9% 10 ML SI IV AP 0.0000 0.4800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 26981 SORO FISIOLOGICO 0,9% 10 ML SI IV AP 0.0000 0.4800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 00404 LACTULOSE 667 MG/ML XP VO ML 0.0000 6.4300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 00404 LACTULOSE 667 MG/ML XP VO ML 0.0000 6.4300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 00487 RANITIDINA 25 MG/ML 2 ML SI IM IV AP 0.0000 0.9300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.4000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1769 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1771 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1771 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1771 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1771 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1771 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1771 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 081fdadb830fb547e83c43fabdb88372 ELZA 12377335349 NULL 12377335349 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 081fdadb830fb547e83c43fabdb88372 ELZA 12377335349 NULL 12377335349 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 081fdadb830fb547e83c43fabdb88372 ELZA 12377335349 NULL 12377335349 00097 ABOCATH N 14 A 22 UN 0.0000 3.7700 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 081fdadb830fb547e83c43fabdb88372 ELZA 12377335349 NULL 12377335349 00098 ABOCATH N 14 A 22 UN 0.0000 3.7700 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 24571 CLINDAMICINA 600 MG 4 ML SI IM IV AP 0.0000 13.0800 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 24571 CLINDAMICINA 600 MG 4 ML SI IM IV AP 0.0000 13.0800 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 24571 CLINDAMICINA 600 MG 4 ML SI IM IV AP 0.0000 13.0800 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 24571 CLINDAMICINA 600 MG 4 ML SI IM IV AP 0.0000 13.0800 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 00406 FUROSEMIDA 10 MG/ML 2 ML SI IM IV AP 0.0000 0.6000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 00406 FUROSEMIDA 10 MG/ML 2 ML SI IM IV AP 0.0000 0.6000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 00406 FUROSEMIDA 10 MG/ML 2 ML SI IM IV AP 0.0000 0.6000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 00406 FUROSEMIDA 10 MG/ML 2 ML SI IM IV AP 0.0000 1.2000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 44001 BOLSA COLETORA (SISTEMA ABERTO) UN 0.0000 0.3200 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 00487 RANITIDINA 25 MG/ML 2 ML SI IM IV AP 0.0000 0.9300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.8100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.8100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.8100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 51379 SERINGA DESC 05 ML UN 0.0000 0.1900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 51379 SERINGA DESC 05 ML UN 0.0000 0.1900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 51497 ESPIRONOLACTONA 50 MG + HIDROCLOROTIAZIDA 50 MG 0.0000 0.9800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 51497 ESPIRONOLACTONA 50 MG + HIDROCLOROTIAZIDA 50 MG 0.0000 0.9800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 00541 AMIODARONA 200 MG CP VO UN 0.0000 0.8400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 00541 AMIODARONA 200 MG CP VO UN 0.0000 0.8400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 00541 AMIODARONA 200 MG CP VO UN 0.0000 0.8400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 06400 CARVEDILOL 3,125 MG CP VO UN 0.0000 0.7300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 06400 CARVEDILOL 3,125 MG CP VO UN 0.0000 0.7300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 102001 DIARIA DE APARTAMENTO 0.0000 288.8900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 11325 EQUIPO MACRO-GOTAS FLEXIVEL C/ INJETOR LATERAL UN 0.0000 1.5900 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 51589 ESPARADRAPO 10 X 4.5 CM CM 0.0000 0.4000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 51649 ALCOOL ETILICO 70 % ST TP ML 0.0000 0.0300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 00090 SERINGA DESC 20 ML UN 0.0000 0.5400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 00919 ALGODAO HIDROFILO BOLINHA UN 0.0000 0.2600 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 f3ad474c8c562757c4d1a959ff0961c4 DJALMA 12718763240 NULL 12718763240 00037 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 f3ad474c8c562757c4d1a959ff0961c4 DJALMA 12718763240 NULL 12718763240 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 f3ad474c8c562757c4d1a959ff0961c4 DJALMA 12718763240 NULL 12718763240 51584 ESPARADRAPO MICROPORE 0.0000 0.7700 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 f3ad474c8c562757c4d1a959ff0961c4 DJALMA 12718763240 NULL 12718763240 51588 ESPARADRAPO MICROPORE 50 X 10 CM CM 0.0000 0.7700 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 f3ad474c8c562757c4d1a959ff0961c4 DJALMA 12718763240 NULL 12718763240 00090 SERINGA DESC 20 ML UN 0.0000 0.5400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 806bfa8e76209648a4ae145ff436d092 GILBERTO 12692620640 NULL 12692620640 20010010 Eletrocardiograma - Ecg 0.0000 0.1200 NULL EXAME SEM REGISTRO DE EXECUCAO 2703
Glosa Min 2018-10-03 00:00:00.000000 1084117 806bfa8e76209648a4ae145ff436d092 GILBERTO 12692620640 NULL 12692620640 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6875 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 806bfa8e76209648a4ae145ff436d092 GILBERTO 12692620640 NULL 12692620640 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6875 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 806bfa8e76209648a4ae145ff436d092 GILBERTO 12692620640 NULL 12692620640 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6875 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3fb5c891f31bb9efcb05395066127c52 ALAIDE 12636273441 NULL 12636273441 14250 PARACETAMOL 750 MG CP VO UN 0.0000 0.0000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3fb5c891f31bb9efcb05395066127c52 ALAIDE 12636273441 NULL 12636273441 14250 PARACETAMOL 750 MG CP VO UN 0.0000 0.4500 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00090 SERINGA DESC 20 ML UN 0.5400 0.2200 0.3200 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00090 SERINGA DESC 20 ML UN 0.5400 0.2200 0.3200 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.6900 0.2700 0.4200 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.6900 0.2700 0.4200 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.6900 0.2700 0.4200 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.6900 0.2700 0.4200 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.6900 0.2700 0.4200 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.6900 0.2700 0.4200 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.6900 0.2700 0.4200 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.6900 0.2700 0.4200 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00493 BROMOPRIDA 5 MG/ML 2 ML SI IM IV AP 2.7300 1.0600 1.6700 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00493 BROMOPRIDA 5 MG/ML 2 ML SI IM IV AP 2.7300 1.0600 1.6700 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 53144 TRAMAL 5.9900 2.3300 3.6600 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 25030019 Distúrbios Circulatórios Artério - Venosos e Linfáticos 11.4600 4.4700 6.9900 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 16b1e9f62f247f02ad5cac910ee15b4e BERCHOLINA 12631612848 NULL 12631612848 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4081 0.0019 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 16b1e9f62f247f02ad5cac910ee15b4e BERCHOLINA 12631612848 NULL 12631612848 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4081 0.0019 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 16b1e9f62f247f02ad5cac910ee15b4e BERCHOLINA 12631612848 NULL 12631612848 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4081 0.0019 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 16b1e9f62f247f02ad5cac910ee15b4e BERCHOLINA 12631612848 NULL 12631612848 19160 SERINGA DESC 20 ML UN 0.5400 0.5386 0.0014 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 16b1e9f62f247f02ad5cac910ee15b4e BERCHOLINA 12631612848 NULL 12631612848 33219 LUVA DE PROCEDIMENTO UNIDADE UN 0.8370 1.0018 -0.3318 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 16b1e9f62f247f02ad5cac910ee15b4e BERCHOLINA 12631612848 NULL 12631612848 00171 SORO FISIOLOGICO 0,9% 250 ML SI IV BS 3.9400 3.7600 0.1800 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 01081195 eb2a9408781bd23e7832b0d68b2d112e KAROLAYNE 12750768110 NULL 12750768110 00010014 CONSULTA EM CONSULTORIO MEDICO 0.0000 0.0000 50.0000 GUIA DE CONSULTA NAO EXECUTADA 0622
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd6f8d6c53ffe9bfd3aa9590ba500cc8 ILDA 12751932542 NULL 12751932542 05975 COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER 1.2000 0.3800 0.8200 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 05975 COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER 0.3000 0.1500 0.1500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 53660 EQUIPO MACRO-GOTAS FLEXIVEL C/ INJETOR LATE 1.5900 0.0000 1.5900 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 08648 ESPARADRAPO 10 X 4.5 CM CM 0.4000 0.2000 0.2000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 33219 LUVA DE PROCEDIMENTO UNIDADE UN 1.6700 0.6700 1.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 57495 FILTRO BARREIRA E REGENERADOR DE CALOR E UM 24.0000 0.0000 24.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 28959 DERSANI LC TP ML 29.1000 9.7000 19.4000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 27316 EQUIPO P/ DIETA ENTERAL UN 1.7000 0.0000 1.7000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 37761 ALCOOL ETILICO 70 % ST TP ML 0.0300 0.0000 0.0300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 75bcd473a0dc7c7a6751499b38a4a034 JOAQUIM 12692852143 NULL 12692852143 00817 ALGODAO HIDROFILO BOLINHA UN 0.2600 0.1300 0.1300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 75bcd473a0dc7c7a6751499b38a4a034 JOAQUIM 12692852143 NULL 12692852143 00817 ALGODAO HIDROFILO BOLINHA UN 0.2600 0.1300 0.1300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 4668d2494ed6c4b2d18be299efcb26a2 JOAO 12469689344 NULL 12469689344 11193 CLOREXIDINA 2 % ST TP ML 0.5300 0.2700 0.2600 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 22756 LIDOCAINA 2% S/ VASO SI PE ML 0.2300 0.0000 0.2300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 0.0000 3.4100 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 14370 FIO MONONYLON 3-0 C/ AGULHA 2,4 3/8 163T E 6.6900 0.0000 6.6900 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 22756 LIDOCAINA 2% S/ VASO SI PE ML 0.9400 0.0000 0.9400 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12603877940 NULL 12603877940 33219 LUVA DE PROCEDIMENTO UNIDADE UN 1.6700 0.0000 1.6700 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12603877940 NULL 12603877940 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.0000 0.1000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 33219 LUVA DE PROCEDIMENTO UNIDADE UN 1.0000 0.6700 0.3300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 00817 ALGODAO HIDROFILO BOLINHA UN 0.2600 0.1300 0.1300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 33219 LUVA DE PROCEDIMENTO UNIDADE UN 1.0000 0.6700 0.3300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 37761 ALCOOL ETILICO 70 % ST TP ML 0.0300 0.0200 0.0100 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 08648 ESPARADRAPO 10 X 4.5 CM CM 0.4000 0.0000 0.4000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 28959 DERSANI LC TP ML 19.4000 9.7000 9.7000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 11193 CLOREXIDINA 2 % ST TP ML 0.5300 0.2700 0.2600 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00817 ALGODAO HIDROFILO BOLINHA UN 0.2600 0.1300 0.1300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 28959 DERSANI LC TP ML 19.4000 9.7000 9.7000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 32891 EQUIPO POLIFIX 2ş VIAS UN 2.5500 0.0000 2.5500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 20559 SORO FISIOLOGICO 0,9% 250 ML SI IV BS 3.9400 0.0000 3.9400 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12558131243 NULL 12558131243 37761 ALCOOL ETILICO 70 % ST TP ML 0.0600 0.0300 0.0300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12558131243 NULL 12558131243 08664 ESPARADRAPO MICROPORE 50 X 10 CM CM 0.7700 0.2600 0.5100 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 37761 ALCOOL ETILICO 70 % ST TP ML 0.0300 0.0200 0.0100 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 7c2bc8cd9bbf9ce081562a3c63fff8c9 MARTA 12647505849 NULL 12647505849 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1756 0.0044 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 f65f553befc0e3bc8bd5bce5c1c6e413 NAIRLENE 12633078944 NULL 12633078944 33219 LUVA DE PROCEDIMENTO UNIDADE UN 1.6700 1.6650 0.0050 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 f65f553befc0e3bc8bd5bce5c1c6e413 NAIRLENE 12633078944 NULL 12633078944 19160 SERINGA DESC 20 ML UN 0.5400 0.5367 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 f65f553befc0e3bc8bd5bce5c1c6e413 NAIRLENE 12633078944 NULL 12633078944 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4067 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 f65f553befc0e3bc8bd5bce5c1c6e413 NAIRLENE 12633078944 NULL 12633078944 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4067 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 f65f553befc0e3bc8bd5bce5c1c6e413 NAIRLENE 12633078944 NULL 12633078944 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4067 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 f65f553befc0e3bc8bd5bce5c1c6e413 NAIRLENE 12633078944 NULL 12633078944 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1760 0.0040 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 f65f553befc0e3bc8bd5bce5c1c6e413 NAIRLENE 12633078944 NULL 12633078944 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1760 0.0040 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 f65f553befc0e3bc8bd5bce5c1c6e413 NAIRLENE 12633078944 NULL 12633078944 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1760 0.0040 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 f65f553befc0e3bc8bd5bce5c1c6e413 NAIRLENE 12633078944 NULL 12633078944 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1760 0.0040 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 c2bcdc3cbedb73a0db271ac09d4587a1 ORDETE 12694018147 NULL 12694018147 08664 ESPARADRAPO MICROPORE 50 X 10 CM CM 0.7700 0.7600 0.0000 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 c2bcdc3cbedb73a0db271ac09d4587a1 ORDETE 12694018147 NULL 12694018147 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1760 0.0040 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 f93cee6f501560245a8f94ffc5c6c246 ROSEDALIA 12622895145 NULL 12622895145 19160 SERINGA DESC 20 ML UN 0.5400 0.5373 0.0027 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 f93cee6f501560245a8f94ffc5c6c246 ROSEDALIA 12622895145 NULL 12622895145 19160 SERINGA DESC 20 ML UN 0.5400 0.5373 0.0027 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 f93cee6f501560245a8f94ffc5c6c246 ROSEDALIA 12622895145 NULL 12622895145 19160 SERINGA DESC 20 ML UN 0.5400 0.5373 0.0027 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 d4089ccef13567fd45b16fb0b60685fa VERA 12640482546 NULL 12640482546 27480 CLARITROMICINA 500 MG 30 ML PO IV FA 117.1100 117.1050 0.0050 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 d4089ccef13567fd45b16fb0b60685fa VERA 12640482546 NULL 12640482546 27480 CLARITROMICINA 500 MG 30 ML PO IV FA 117.1100 117.1050 0.0050 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 d4089ccef13567fd45b16fb0b60685fa VERA 12640482546 NULL 12640482546 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1754 0.0046 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 d4089ccef13567fd45b16fb0b60685fa VERA 12640482546 NULL 12640482546 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1754 0.0046 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 d4089ccef13567fd45b16fb0b60685fa VERA 12640482546 NULL 12640482546 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1754 0.0046 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4074 0.0026 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4074 0.0026 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4074 0.0026 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4074 0.0026 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4074 0.0026 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4074 0.0026 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 6.8200 6.8149 0.0051 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 19160 SERINGA DESC 20 ML UN 0.5400 0.5368 0.0032 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 19160 SERINGA DESC 20 ML UN 0.5400 0.5372 0.0028 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 19160 SERINGA DESC 20 ML UN 0.5400 0.5372 0.0028 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 19160 SERINGA DESC 20 ML UN 0.5400 0.5372 0.0028 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 eecb3d883747b059c3fe231c34567476 AFFRIDES 12693180144 NULL 12693180144 19160 SERINGA DESC 20 ML UN 0.5400 0.5372 0.0028 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1d6bbb4a00130e2e654e830fc9bae6a ALEXANDRINA 12694224940 NULL 12694224940 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1700 0.0000 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1d6bbb4a00130e2e654e830fc9bae6a ALEXANDRINA 12694224940 NULL 12694224940 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4072 0.0028 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1d6bbb4a00130e2e654e830fc9bae6a ALEXANDRINA 12694224940 NULL 12694224940 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4072 0.0028 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1d6bbb4a00130e2e654e830fc9bae6a ALEXANDRINA 12694224940 NULL 12694224940 19160 SERINGA DESC 20 ML UN 0.5400 0.5367 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1d6bbb4a00130e2e654e830fc9bae6a ALEXANDRINA 12694224940 NULL 12694224940 19160 SERINGA DESC 20 ML UN 0.5400 0.5367 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1d6bbb4a00130e2e654e830fc9bae6a ALEXANDRINA 12694224940 NULL 12694224940 19160 SERINGA DESC 20 ML UN 0.5400 0.5367 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1d6bbb4a00130e2e654e830fc9bae6a ALEXANDRINA 12694224940 NULL 12694224940 19160 SERINGA DESC 20 ML UN 0.5400 0.5367 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1d6bbb4a00130e2e654e830fc9bae6a ALEXANDRINA 12694224940 NULL 12694224940 19160 SERINGA DESC 20 ML UN 0.5400 0.5367 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1d6bbb4a00130e2e654e830fc9bae6a ALEXANDRINA 12694224940 NULL 12694224940 19160 SERINGA DESC 20 ML UN 0.5400 0.5367 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 345c226bfea274af1372d41b0305a6c8 ALTINO 12720257940 NULL 12720257940 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1000 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 345c226bfea274af1372d41b0305a6c8 ALTINO 12720257940 NULL 12720257940 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1000 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1038 -0.0038 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1038 -0.0038 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1038 -0.0038 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1038 -0.0038 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1038 -0.0038 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 19160 SERINGA DESC 20 ML UN 0.5400 0.5378 0.0022 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 19160 SERINGA DESC 20 ML UN 0.5400 0.5378 0.0022 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 19160 SERINGA DESC 20 ML UN 0.5400 0.5378 0.0022 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1797 0.0003 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1797 0.0003 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1797 0.0003 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1797 0.0003 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1900 0.1797 0.0103 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e3731e8ac87e0066ebac4c8795b1893e FRANCISCA 12607435740 NULL 12607435740 20567 SORO FISIOLOGICO 0,9% 500 ML SI IV BS 4.7300 4.7350 -0.0050 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 05975 COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER 0.3000 0.0000 0.3000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 08648 ESPARADRAPO 10 X 4.5 CM CM 0.4000 0.0000 0.4000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 05975 COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER 0.3000 0.0000 0.3000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 05975 COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER 0.3000 0.0000 0.3000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 05975 COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER 0.3000 0.0000 0.3000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 b288bbcfb9aecab51bcb0dba62ca0059 IVONETE 12743730847 NULL 12743730847 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4063 0.0037 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 19496 METILPREDNISOLONA (SUCCINATO SODICO) 125 MG 30.5600 30.5500 0.0000 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 32891 EQUIPO POLIFIX 2ş VIAS UN 2.5500 0.0000 2.5500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 27480 CLARITROMICINA 500 MG 30 ML PO IV FA 117.1100 117.1050 0.0050 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1758 0.0042 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1758 0.0042 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1758 0.0042 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1758 0.0042 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1758 0.0042 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1758 0.0042 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4084 0.0016 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4084 0.0016 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4084 0.0016 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4084 0.0016 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4084 0.0016 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4084 0.0016 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 19160 SERINGA DESC 20 ML UN 0.5400 0.5372 0.0028 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 19160 SERINGA DESC 20 ML UN 0.5400 0.5384 0.0016 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 19160 SERINGA DESC 20 ML UN 0.5400 0.5384 0.0016 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 19160 SERINGA DESC 20 ML UN 0.5400 0.5384 0.0016 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 20cbe2e07b1dcd2b6af609a50df7ae80 LUCELENA 12690767849 NULL 12690767849 19160 SERINGA DESC 20 ML UN 0.5400 0.5384 0.0016 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 32204 CLORETO DE SODIO 0,9% 10 ML SI IV AP 0.9600 0.0000 0.9600 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 19445 CLORETO DE POTASSIO 600 MG CA VO UN 0.4900 0.4867 0.0033 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 19445 CLORETO DE POTASSIO 600 MG CA VO UN 0.4900 0.4867 0.0033 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4075 0.0025 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4075 0.0025 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4075 0.0025 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4075 0.0025 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4075 0.0025 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4075 0.0025 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 07269 DIPIRONA 500 MG/ML 2 ML SI IV IM AP 0.6900 0.6883 0.0017 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 07269 DIPIRONA 500 MG/ML 2 ML SI IV IM AP 0.6900 0.6865 0.0035 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 07269 DIPIRONA 500 MG/ML 2 ML SI IV IM AP 0.6900 0.6865 0.0035 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 07269 DIPIRONA 500 MG/ML 2 ML SI IV IM AP 0.6900 0.6865 0.0035 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 07269 DIPIRONA 500 MG/ML 2 ML SI IV IM AP 0.6900 0.6865 0.0035 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 07269 DIPIRONA 500 MG/ML 2 ML SI IV IM AP 0.6900 0.6865 0.0035 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 19160 SERINGA DESC 20 ML UN 0.5400 0.5375 0.0025 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 19160 SERINGA DESC 20 ML UN 0.5400 0.5375 0.0025 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1769 0.0031 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1769 0.0031 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8073 0.0027 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8073 0.0027 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 19160 SERINGA DESC 20 ML UN 0.5400 0.5372 0.0028 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 19160 SERINGA DESC 20 ML UN 0.5400 0.5372 0.0028 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 19160 SERINGA DESC 20 ML UN 0.5400 0.5372 0.0028 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 19160 SERINGA DESC 20 ML UN 0.5400 0.5372 0.0028 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1779 0.0021 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1779 0.0021 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 08664 ESPARADRAPO MICROPORE 50 X 10 CM CM 0.2600 0.2558 0.0042 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 08664 ESPARADRAPO MICROPORE 50 X 10 CM CM 0.2600 0.2558 0.0042 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 08664 ESPARADRAPO MICROPORE 50 X 10 CM CM 0.2600 0.2558 0.0042 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 08664 ESPARADRAPO MICROPORE 50 X 10 CM CM 0.2600 0.2558 0.0042 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e2b254ce765be196b019032789d8f852 MARIA 12576216044 NULL 12576216044 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4078 0.0022 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 32891 EQUIPO POLIFIX 2ş VIAS UN 2.5500 0.0000 2.5500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 32891 EQUIPO POLIFIX 2ş VIAS UN 2.5500 2.5500 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 32891 EQUIPO POLIFIX 2ş VIAS UN 2.5500 0.0000 2.5500 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 d17b3c5ae418d82694895a326dee545a ODILIA 12670516743 NULL 12670516743 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1774 0.0026 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 d17b3c5ae418d82694895a326dee545a ODILIA 12670516743 NULL 12670516743 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1774 0.0026 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 d17b3c5ae418d82694895a326dee545a ODILIA 12670516743 NULL 12670516743 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1774 0.0026 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 6ccea6ac8c216c032723aee73a9f81c9 PRISCILA 12662249242 NULL 12662249242 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4067 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 6ccea6ac8c216c032723aee73a9f81c9 PRISCILA 12662249242 NULL 12662249242 07269 DIPIRONA 500 MG/ML 2 ML SI IV IM AP 0.6900 0.6864 0.0036 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 6ccea6ac8c216c032723aee73a9f81c9 PRISCILA 12662249242 NULL 12662249242 07269 DIPIRONA 500 MG/ML 2 ML SI IV IM AP 0.6900 0.6864 0.0036 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 6ccea6ac8c216c032723aee73a9f81c9 PRISCILA 12662249242 NULL 12662249242 07269 DIPIRONA 500 MG/ML 2 ML SI IV IM AP 0.6900 0.6864 0.0036 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1000 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1000 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1000 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1000 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1000 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1000 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1000 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1000 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1000 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1000 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.1000 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.0000 0.8100 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 33227 LUVA CIRURGICA PAR UN 1.4500 1.4476 0.0024 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 19151 SERINGA DESC 10 ML UN 0.3300 0.3333 -0.0033 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 19160 SERINGA DESC 20 ML UN 0.5400 0.5384 0.0016 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 19160 SERINGA DESC 20 ML UN 0.5400 0.5384 0.0016 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 32891 EQUIPO POLIFIX 2ş VIAS UN 2.5500 2.5500 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1776 0.0024 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1776 0.0024 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1776 0.0024 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1776 0.0024 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8092 0.0008 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8092 0.0008 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 11193 CLOREXIDINA 2 % ST TP ML 0.5300 0.5300 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 0111beed375944f60c7ad4a7fd4874f8 WALDIR 12746025744 NULL 12746025744 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1773 0.0027 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 0111beed375944f60c7ad4a7fd4874f8 WALDIR 12746025744 NULL 12746025744 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1773 0.0027 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 0111beed375944f60c7ad4a7fd4874f8 WALDIR 12746025744 NULL 12746025744 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1773 0.0027 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 0111beed375944f60c7ad4a7fd4874f8 WALDIR 12746025744 NULL 12746025744 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1773 0.0027 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 0111beed375944f60c7ad4a7fd4874f8 WALDIR 12746025744 NULL 12746025744 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8074 0.0026 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 05975 COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER 0.3000 0.0000 0.3000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8079 0.0021 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8079 0.0021 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8079 0.0021 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 08435 EQUIPO P/ BOMBA DE INFUSAO ENTERAL / PARENT 20.2800 20.2775 0.0025 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 75bcd473a0dc7c7a6751499b38a4a034 JOAQUIM 12692852143 NULL 12692852143 37761 ALCOOL ETILICO 70 % ST TP ML 0.0300 0.0000 0.0300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 75bcd473a0dc7c7a6751499b38a4a034 JOAQUIM 12692852143 NULL 12692852143 53660 EQUIPO MACRO-GOTAS FLEXIVEL C/ INJETOR LATE 1.5900 1.5900 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 610c198ec4c064687cf0524f147d3aed ROBERTO 12748814743 NULL 12748814743 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1767 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 610c198ec4c064687cf0524f147d3aed ROBERTO 12748814743 NULL 12748814743 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1767 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 610c198ec4c064687cf0524f147d3aed ROBERTO 12748814743 NULL 12748814743 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4083 0.0017 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 610c198ec4c064687cf0524f147d3aed ROBERTO 12748814743 NULL 12748814743 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4083 0.0017 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12647284040 NULL 12647284040 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4080 0.0020 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12647284040 NULL 12647284040 00590 AGULHA DESC 30 X 7 - 40X12 UN 0.1800 0.1750 0.0050 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12647284040 NULL 12647284040 08664 ESPARADRAPO MICROPORE 50 X 10 CM CM 0.7700 0.7667 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12647284040 NULL 12647284040 20567 SORO FISIOLOGICO 0,9% 500 ML SI IV BS 9.4700 9.4697 0.0003 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12647284040 NULL 12647284040 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4086 0.0014 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12647284040 NULL 12647284040 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4086 0.0014 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12647284040 NULL 12647284040 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4086 0.0014 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12647284040 NULL 12647284040 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4086 0.0014 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12647284040 NULL 12647284040 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4086 0.0014 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12647284040 NULL 12647284040 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4086 0.0014 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 11193 CLOREXIDINA 2 % ST TP ML 0.5300 0.0000 0.5300 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 33545 PIPERACILINA 4 G + TAZOBACTAM 500 MG PO IV 83.4500 83.4500 0.0000 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 6.8156 -3.4056 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 6.8145 -3.4045 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 6.8145 -3.4045 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 6.8145 -3.4045 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 6.8145 -3.4045 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 6.8145 -3.4045 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4072 0.0028 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 57835 SORO FISIOLOGICO 0,9% 100 ML SI IV BS 3.4100 3.4072 0.0028 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.2120 -0.1120 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.2120 -0.1120 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.2120 -0.1120 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.2120 -0.1120 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00558 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.1000 0.2120 -0.1120 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 19160 SERINGA DESC 20 ML UN 0.5400 0.5374 0.0026 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 19160 SERINGA DESC 20 ML UN 0.5400 0.5374 0.0026 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 19160 SERINGA DESC 20 ML UN 0.5400 0.5374 0.0026 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 19160 SERINGA DESC 20 ML UN 0.5400 0.5374 0.0026 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 19160 SERINGA DESC 20 ML UN 0.5400 0.5374 0.0026 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 19160 SERINGA DESC 20 ML UN 0.5400 0.5374 0.0026 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 19160 SERINGA DESC 20 ML UN 0.5400 0.5374 0.0026 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 19160 SERINGA DESC 20 ML UN 0.5400 0.5374 0.0026 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 19160 SERINGA DESC 20 ML UN 0.5400 0.5374 0.0026 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 19160 SERINGA DESC 20 ML UN 0.5400 0.5374 0.0026 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.4000 0.4037 -0.0037 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.4000 0.4037 -0.0037 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8073 0.0027 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8073 0.0027 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8073 0.0027 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8073 0.0027 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8073 0.0027 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00426 AGUA BIDESTILADA 10 ML SI IV IM AP 0.8100 0.8073 0.0027 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 33219 LUVA DE PROCEDIMENTO UNIDADE UN 1.0000 1.0050 -0.0050 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 09636 FLORATIL (SACCHAROMYCES BOULARDII) 200 MG P 8.8826 13.3278 -8.8878 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 09636 FLORATIL (SACCHAROMYCES BOULARDII) 200 MG P 4.4400 8.8851 -4.4451 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 09636 FLORATIL (SACCHAROMYCES BOULARDII) 200 MG P 4.4400 8.8851 -4.4451 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 27600 ONDANSETRONA 2 MG/ML 4 ML SI IM IV AP 81.1800 94.7100 -81.1800 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 19445 CLORETO DE POTASSIO 600 MG CA VO UN 1.4637 1.9474 -1.4574 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 05975 COMPRESSAS DE GAZES 7.5 X7,5 (11 FIOS ESTER 0.7739 0.8059 -0.7759 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 08664 ESPARADRAPO MICROPORE 50 X 10 CM CM 1.1320 1.1546 -0.8946 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 08664 ESPARADRAPO MICROPORE 50 X 10 CM CM 1.1064 1.1285 -0.8685 MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1d6bbb4a00130e2e654e830fc9bae6a ALEXANDRINA 12694224940 NULL 12694224940 05274 AMOXICILINA 500 MG + CLAVULANATO 125 MG CP 3.1700 3.1666 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1d6bbb4a00130e2e654e830fc9bae6a ALEXANDRINA 12694224940 NULL 12694224940 05274 AMOXICILINA 500 MG + CLAVULANATO 125 MG CP 3.1700 3.1666 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1d6bbb4a00130e2e654e830fc9bae6a ALEXANDRINA 12694224940 NULL 12694224940 05274 AMOXICILINA 500 MG + CLAVULANATO 125 MG CP 3.1700 3.1666 0.0033 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 000445 TAXA DE TRANSPORTE E INSTALACAO DE EQUIPAMENTO DE NULL 0.0000 NULL OPME INVALIDO 2201
Glosa Min 2018-10-03 00:00:00.000000 1084117 900c66260626ee704d2ca7bb91ae2f1c MARIA 12705991543 NULL 12705991543 51584 ESPARADRAPO MICROPORE NULL 0.0000 NULL OPME INVALIDO 2201
Glosa Min 2018-10-03 00:00:00.000000 1084117 800720d33fe0defb6121e82dd216d044 JALMO 12786952647 NULL 12786952647 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 800720d33fe0defb6121e82dd216d044 JALMO 12786952647 NULL 12786952647 51241 AGULHA 123X45 0.0000 0.1900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 800720d33fe0defb6121e82dd216d044 JALMO 12786952647 NULL 12786952647 00757 CEFUROXIMA 750 MG + DIL. 6 ML PO IM IV FA 0.0000 26.1300 NULL VALOR APRESENTADO A MAIOR 1705
Glosa Min 2018-10-03 00:00:00.000000 1084117 752c651cb4fd049e19c685f87fbe8bdc EDUARDO 12765990646 NULL 12765990646 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6875 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 752c651cb4fd049e19c685f87fbe8bdc EDUARDO 12765990646 NULL 12765990646 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 752c651cb4fd049e19c685f87fbe8bdc EDUARDO 12765990646 NULL 12765990646 53975 Hemifumarato De Quetiapina 25mg ? Cp 0.0000 1.2450 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 752c651cb4fd049e19c685f87fbe8bdc EDUARDO 12765990646 NULL 12765990646 53975 Hemifumarato De Quetiapina 25mg ? Cp 0.0000 1.2500 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 752c651cb4fd049e19c685f87fbe8bdc EDUARDO 12765990646 NULL 12765990646 53975 Hemifumarato De Quetiapina 25mg ? Cp 0.0000 1.2450 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12558131243 NULL 12558131243 52010341 Hérnia Discal - Tratamento Cirúrgico 0.0000 0.0000 NULL COBRANCA DE HONORARIOS EM DUPLICIDADE 2607
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12558131243 NULL 12558131243 52010511 Fratura do Cóccix - Tratamento Cruento 0.0000 0.0000 NULL COBRANCA DE HONORARIOS EM DUPLICIDADE 2607
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12558131243 NULL 12558131243 52010511 Fratura do Cóccix - Tratamento Cruento 0.0000 0.0000 NULL COBRANCA DE HONORARIOS EM DUPLICIDADE 2607
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12558131243 NULL 12558131243 52010511 Fratura do Cóccix - Tratamento Cruento 0.0000 0.0000 NULL COBRANCA DE HONORARIOS EM DUPLICIDADE 2607
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12558131243 NULL 12558131243 52010511 Fratura do Cóccix - Tratamento Cruento 0.0000 0.0000 NULL COBRANCA DE HONORARIOS EM DUPLICIDADE 2607
Glosa Min 2018-10-03 00:00:00.000000 1084117 526685c1041cc1316e874a2e95e67e2e JOSE 12696604949 NULL 12696604949 00169 SORO GLICOSADO 5% 500 ML SI IV BS 0.0000 5.1900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 526685c1041cc1316e874a2e95e67e2e JOSE 12696604949 NULL 12696604949 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1760 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 526685c1041cc1316e874a2e95e67e2e JOSE 12696604949 NULL 12696604949 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1760 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 526685c1041cc1316e874a2e95e67e2e JOSE 12696604949 NULL 12696604949 00095 ABOCATH N 14 A 22 UN 0.0000 0.3200 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 11232 CLEXANE (ENOXAPARINA) 40 MG SI IV SC SE 0.0000 38.9400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 11700 EQUIPO P/ BOMBA DE INFUSAO ENTERAL / PARENTERAL 0.0000 20.2800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 11700 EQUIPO P/ BOMBA DE INFUSAO ENTERAL / PARENTERAL 0.0000 0.0000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.0000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.0000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.0000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.0000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.0000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.0000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.0000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.4000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.4000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 51164 AGUA BIDESTILADA 500 ML 0.0000 6.4300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 51164 AGUA BIDESTILADA 500 ML 0.0000 6.4300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.0000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.0000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 51379 SERINGA DESC 05 ML UN 0.0000 0.1900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 51379 SERINGA DESC 05 ML UN 0.0000 0.1900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 51379 SERINGA DESC 05 ML UN 0.0000 0.1900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 51434 BECLOMETASONA 400 MCG / ML 2 ML SL IN FL 0.0000 4.4800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 51434 BECLOMETASONA 400 MCG / ML 2 ML SL IN FL 0.0000 4.4800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 51434 BECLOMETASONA 400 MCG / ML 2 ML SL IN FL 0.0000 4.4800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 51708 Dieta Hipercalorica Hiperproteica Sem Fibras 1.5 kcal 0.0000 73.4000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 51708 Dieta Hipercalorica Hiperproteica Sem Fibras 1.5 kcal 0.0000 73.4000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 734612c551b837fa6a288126bac538d4 MARIA 12574536240 NULL 12574536240 00613 CLINDAMICINA 600 MG 4 ML SI IM IV AP 0.0000 13.0800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 4e13adf421809cb755e1bdd80cc4efed AGRIPINA 12385409142 NULL 12385409142 201005 TAXA DE SALA PORTE IV 0.0000 500.6800 NULL VALOR APRESENTADO A MAIOR 1705
Glosa Min 2018-10-03 00:00:00.000000 1084117 4e13adf421809cb755e1bdd80cc4efed AGRIPINA 12385409142 NULL 12385409142 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 4e13adf421809cb755e1bdd80cc4efed AGRIPINA 12385409142 NULL 12385409142 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.4000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 4e13adf421809cb755e1bdd80cc4efed AGRIPINA 12385409142 NULL 12385409142 51379 SERINGA DESC 05 ML UN 0.0000 0.5800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 4e13adf421809cb755e1bdd80cc4efed AGRIPINA 12385409142 NULL 12385409142 00090 SERINGA DESC 20 ML UN 0.0000 0.5300 NULL VALOR APRESENTADO A MAIOR 1705
Glosa Min 2018-10-03 00:00:00.000000 1084117 75bcd473a0dc7c7a6751499b38a4a034 JOAQUIM 12692852143 NULL 12692852143 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4075 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 75bcd473a0dc7c7a6751499b38a4a034 JOAQUIM 12692852143 NULL 12692852143 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4075 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 75bcd473a0dc7c7a6751499b38a4a034 JOAQUIM 12692852143 NULL 12692852143 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 75bcd473a0dc7c7a6751499b38a4a034 JOAQUIM 12692852143 NULL 12692852143 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4075 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 75bcd473a0dc7c7a6751499b38a4a034 JOAQUIM 12692852143 NULL 12692852143 01652 TRAMADOL 50 MG CP VO UN 0.0000 1.9272 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 75bcd473a0dc7c7a6751499b38a4a034 JOAQUIM 12692852143 NULL 12692852143 01652 TRAMADOL 50 MG CP VO UN 0.0000 1.9272 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 75bcd473a0dc7c7a6751499b38a4a034 JOAQUIM 12692852143 NULL 12692852143 01652 TRAMADOL 50 MG CP VO UN 0.0000 1.9272 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 75bcd473a0dc7c7a6751499b38a4a034 JOAQUIM 12692852143 NULL 12692852143 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6850 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 75bcd473a0dc7c7a6751499b38a4a034 JOAQUIM 12692852143 NULL 12692852143 04073 TRAMADOL 50 MG 1 ML SI IM IV AP 0.0000 4.1900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 75bcd473a0dc7c7a6751499b38a4a034 JOAQUIM 12692852143 NULL 12692852143 04073 TRAMADOL 50 MG 1 ML SI IM IV AP 0.0000 4.1900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 75bcd473a0dc7c7a6751499b38a4a034 JOAQUIM 12692852143 NULL 12692852143 04073 TRAMADOL 50 MG 1 ML SI IM IV AP 0.0000 4.1900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 75bcd473a0dc7c7a6751499b38a4a034 JOAQUIM 12692852143 NULL 12692852143 51710 CLORETO DE POTASSIO 15% 10 ML SI IV AP 0.0000 0.6850 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00124 LUVA CIRURGICA UN 0.0000 1.4475 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00124 LUVA CIRURGICA UN 0.0000 1.4475 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 24082 BROMOPRIDA 5 MG/ML 2 ML SI IM IV AP 0.0000 2.7300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 26981 SORO FISIOLOGICO 0,9% 10 ML SI IV AP 0.0000 0.9600 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 26981 SORO FISIOLOGICO 0,9% 10 ML SI IV AP 0.0000 0.9600 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 26981 SORO FISIOLOGICO 0,9% 10 ML SI IV AP 0.0000 0.9600 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 03280 CLOREXIDINA 2 % ST TP ML 0.0000 0.5300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 03280 CLOREXIDINA 2 % ST TP ML 0.0000 0.5300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 03280 CLOREXIDINA 2 % ST TP ML 0.0000 0.5300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6875 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6875 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00487 RANITIDINA 25 MG/ML 2 ML SI IM IV AP 0.0000 0.9300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00487 RANITIDINA 25 MG/ML 2 ML SI IM IV AP 0.0000 0.9300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 54756 HIDANTAL 0.0000 0.1864 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 55795 FOSFATO DE POTASSIO 2 MEQ/ML 10 ML SI IV AP 0.0000 3.0200 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00796 FLORATIL (SACCHAROMYCES BOULARDII) 200 MG PO VO 0.0000 4.4400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12631509346 NULL 12631509346 00796 FLORATIL (SACCHAROMYCES BOULARDII) 200 MG PO VO 0.0000 4.4400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4088 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4088 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4088 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4088 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4088 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4088 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4088 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4088 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4088 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4088 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4088 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 28010337 Cálcio Ionizável 0.0000 0.0000 NULL EXAME NAO AUTORIZADO 2707
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6872 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6872 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6872 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6872 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6872 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6872 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6872 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6872 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6872 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1766 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1766 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a3bfb82253860b1398994277c29a8da8 SEBASTIAO 12269818544 NULL 12269818544 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1766 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4070 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 51584 ESPARADRAPO MICROPORE 0.0000 0.2560 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 51584 ESPARADRAPO MICROPORE 0.0000 0.2560 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 51584 ESPARADRAPO MICROPORE 0.0000 0.2560 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 51584 ESPARADRAPO MICROPORE 0.0000 0.2560 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 51584 ESPARADRAPO MICROPORE 0.0000 0.2560 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 51584 ESPARADRAPO MICROPORE 0.0000 0.2560 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 51584 ESPARADRAPO MICROPORE 0.0000 0.2560 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 52303 NOREPINEFRINA 2 MG/ML 4 ML SI IV AP 0.0000 9.4962 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 52303 NOREPINEFRINA 2 MG/ML 4 ML SI IV AP 0.0000 85.4700 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 9dfc31860f2d2ae957debc955e9c1025 VALDIR 12693932848 NULL 12693932848 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cd2840524be5a3f1d0939f241e24f32b MARIA 12705908340 NULL 12705908340 11232 CLEXANE (ENOXAPARINA) 40 MG SI IV SC SE 0.0000 36.8000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cd2840524be5a3f1d0939f241e24f32b MARIA 12705908340 NULL 12705908340 00181 SULFATO DE MAGNESIO 100 MG/ML 10 ML SI IM IV 0.0000 0.9467 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cd2840524be5a3f1d0939f241e24f32b MARIA 12705908340 NULL 12705908340 00181 SULFATO DE MAGNESIO 100 MG/ML 10 ML SI IM IV 0.0000 0.9467 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cd2840524be5a3f1d0939f241e24f32b MARIA 12705908340 NULL 12705908340 00184 CLORETO DE POTASSIO 10% 10 ML SI IV AP 0.0000 0.2967 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cd2840524be5a3f1d0939f241e24f32b MARIA 12705908340 NULL 12705908340 25040014 Fisioterapia Respiratória - em Doente Clínico Internado 0.0000 0.0000 NULL EXAME SEM REGISTRO DE EXECUCAO 2703
Glosa Min 2018-10-03 00:00:00.000000 1084117 cd2840524be5a3f1d0939f241e24f32b MARIA 12705908340 NULL 12705908340 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cd2840524be5a3f1d0939f241e24f32b MARIA 12705908340 NULL 12705908340 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cd2840524be5a3f1d0939f241e24f32b MARIA 12705908340 NULL 12705908340 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cd2840524be5a3f1d0939f241e24f32b MARIA 12705908340 NULL 12705908340 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1775 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 00090 SERINGA DESC 20 ML UN 0.0000 0.5379 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 00090 SERINGA DESC 20 ML UN 0.0000 0.5379 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 00090 SERINGA DESC 20 ML UN 0.0000 0.5379 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 00090 SERINGA DESC 20 ML UN 0.0000 0.5379 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 ab92e84cfdb4f371201a28fa853db1be IARA 12550571048 NULL 12550571048 00090 SERINGA DESC 20 ML UN 0.0000 0.5379 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 01611 CLORETO DE POTASSIO 600 MG CA VO UN 0.0000 0.4867 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 01611 CLORETO DE POTASSIO 600 MG CA VO UN 0.0000 0.4867 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 01611 CLORETO DE POTASSIO 600 MG CA VO UN 0.0000 0.4867 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 01611 CLORETO DE POTASSIO 600 MG CA VO UN 0.0000 0.4867 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.8078 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.8078 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.8078 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.8078 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.8078 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1773 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1773 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 00090 SERINGA DESC 20 ML UN 0.0000 0.5376 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 00090 SERINGA DESC 20 ML UN 0.0000 0.5376 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 9ffbbf7340bbd65e9e3baa9406d027f3 MARCO 12261811645 NULL 12261811645 00090 SERINGA DESC 20 ML UN 0.0000 0.5376 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4094 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4094 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 01496 FENITOINA 50 MG/ML 5 ML SI IM IV AP 0.0000 2.3400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 01496 FENITOINA 50 MG/ML 5 ML SI IM IV AP 0.0000 2.3400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 01496 FENITOINA 50 MG/ML 5 ML SI IM IV AP 0.0000 2.3400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 00165 DEXAMETASONA 4 MG/ML 2,5 ML SI IM IV FA 0.0000 3.4200 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 02246 HIDROCORTISONA 100 MG PO IM IV FA 0.0000 2.8300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 26981 SORO FISIOLOGICO 0,9% 10 ML SI IV AP 0.0000 0.4800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 26981 SORO FISIOLOGICO 0,9% 10 ML SI IV AP 0.0000 0.9600 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 26981 SORO FISIOLOGICO 0,9% 10 ML SI IV AP 0.0000 0.9600 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 26981 SORO FISIOLOGICO 0,9% 10 ML SI IV AP 0.0000 0.9600 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 52392 SONDA DE ASPIRAÇAO TRAQUEAL C/ VALVULA UN 0.0000 0.9352 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 09070 ACETILCISTEINA 600MG PO VO SA 0.0000 3.4950 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 09070 ACETILCISTEINA 600MG PO VO SA 0.0000 3.4950 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 730a54d9cef9c3809a9e601b24d92900 MIGUEL 12748953246 NULL 12748953246 00090 SERINGA DESC 20 ML UN 0.0000 0.5300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 15f461c0ca379f375bd9f8b18fbb101a ANA 12753753845 NULL 12753753845 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR APRESENTADO A MAIOR 1705
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 01229 FLEET ENEMA (FOSFATO DE SODIO DIBASICO + FOSFATO 0.0000 1.1716 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4072 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4072 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4072 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4072 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4072 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4072 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4072 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4072 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4072 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4072 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4072 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4072 NULL VALOR APRESENTADO A MAIOR 1705
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4072 NULL VALOR APRESENTADO A MAIOR 1705
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4072 NULL COBRANCA DE MEDICAMENTO EM QUANTIDADE INCOMPATIVEL COM A PERMANENCIA 2107
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4072 NULL COBRANCA DE MEDICAMENTO EM QUANTIDADE INCOMPATIVEL COM A PERMANENCIA 2107
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4072 NULL VALOR APRESENTADO A MAIOR 1705
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00184 CLORETO DE POTASSIO 10% 10 ML SI IV AP 0.0000 0.5900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00184 CLORETO DE POTASSIO 10% 10 ML SI IV AP 0.0000 0.5900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00184 CLORETO DE POTASSIO 10% 10 ML SI IV AP 0.0000 0.5900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 02355 AMOXICILINA 1 G + CLAVULANATO 200 MG + DIL. 10 ML 0.0000 36.4667 NULL COBRANCA DE MEDICAMENTO EM QUANTIDADE INCOMPATIVEL COM A PERMANENCIA 2107
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00090 SERINGA DESC 20 ML UN 0.0000 0.5367 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00090 SERINGA DESC 20 ML UN 0.0000 0.5367 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00090 SERINGA DESC 20 ML UN 0.0000 0.5367 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3a7b06385f8e5076d58a2b80b69d3691 MARIA 12607395840 NULL 12607395840 00090 SERINGA DESC 20 ML UN 0.0000 0.5367 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 2e6b6f291f2df9beb1fbda6028678909 ANNA 12463693448 NULL 12463693448 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 2e6b6f291f2df9beb1fbda6028678909 ANNA 12463693448 NULL 12463693448 09070 ACETILCISTEINA 600MG PO VO SA 0.0000 3.5000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 2e6b6f291f2df9beb1fbda6028678909 ANNA 12463693448 NULL 12463693448 09070 ACETILCISTEINA 600MG PO VO SA 0.0000 3.5000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 11325 EQUIPO MACRO-GOTAS FLEXIVEL C/ INJETOR LATERAL UN 0.0000 1.5900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00124 LUVA CIRURGICA UN 0.0000 1.4484 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00124 LUVA CIRURGICA UN 0.0000 1.4478 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00124 LUVA CIRURGICA UN 0.0000 1.4478 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.0000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6871 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6871 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6871 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 35382 COMPRESSAS DE GASES 7.5 X7,5 (11 FIOS ESTERIL) UN 0.0000 0.3000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 35382 COMPRESSAS DE GASES 7.5 X7,5 (11 FIOS ESTERIL) UN 0.0000 0.0000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00487 RANITIDINA 25 MG/ML 2 ML SI IM IV AP 0.0000 0.9300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00487 RANITIDINA 25 MG/ML 2 ML SI IM IV AP 0.0000 0.9300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00487 RANITIDINA 25 MG/ML 2 ML SI IM IV AP 0.0000 0.9300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00487 RANITIDINA 25 MG/ML 2 ML SI IM IV AP 0.0000 0.9300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00487 RANITIDINA 25 MG/ML 2 ML SI IM IV AP 0.0000 0.9300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00487 RANITIDINA 25 MG/ML 2 ML SI IM IV AP 0.0000 0.9300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00487 RANITIDINA 25 MG/ML 2 ML SI IM IV AP 0.0000 0.9300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.4000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.4000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.4000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.4000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.4000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.4000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.4000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.4000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1784 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 51649 ALCOOL ETILICO 70 % ST TP ML 0.0000 0.0300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00090 SERINGA DESC 20 ML UN 0.0000 0.5375 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00090 SERINGA DESC 20 ML UN 0.0000 0.5375 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00090 SERINGA DESC 20 ML UN 0.0000 0.5375 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00090 SERINGA DESC 20 ML UN 0.0000 0.5375 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00090 SERINGA DESC 20 ML UN 0.0000 0.5375 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00090 SERINGA DESC 20 ML UN 0.0000 0.5400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00090 SERINGA DESC 20 ML UN 0.0000 0.5400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00090 SERINGA DESC 20 ML UN 0.0000 0.5375 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00090 SERINGA DESC 20 ML UN 0.0000 0.5375 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00090 SERINGA DESC 20 ML UN 0.0000 0.5375 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 3bbfe282a7573b8ea1e0acb45985f346 FERNANDO 12660127044 NULL 12660127044 00090 SERINGA DESC 20 ML UN 0.0000 0.5375 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 09586cdd4dbbc5a8f142ad1eff19fbe6 VALDECI 12697562440 NULL 12697562440 103001 DIARIA DE U.T.I. UNIDADE DE TERAPIA INTENSIVA 0.0000 1419.1100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 09586cdd4dbbc5a8f142ad1eff19fbe6 VALDECI 12697562440 NULL 12697562440 000441 TAXA DE DELEUCOTIZAÇÃO 0.0000 0.0000 NULL COBRANCA DE OUTRAS TAXAS ASSOCIADAS/INCLUSAS NA COBRANCA DA TAXA DE SALA PREVISTA 2404
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.8074 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.8074 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.8074 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1775 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1775 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1775 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1775 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1775 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1775 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1775 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1775 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1775 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 51584 ESPARADRAPO MICROPORE 0.0000 0.0000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 51671 REPARIL (ESCINA + DIETILAMONIO) GL TP GR 0.0000 0.0000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 00090 SERINGA DESC 20 ML UN 0.0000 0.5375 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 00090 SERINGA DESC 20 ML UN 0.0000 0.5375 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 00090 SERINGA DESC 20 ML UN 0.0000 0.5375 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 00090 SERINGA DESC 20 ML UN 0.0000 0.5375 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 00090 SERINGA DESC 20 ML UN 0.0000 0.5375 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 00090 SERINGA DESC 20 ML UN 0.0000 0.5375 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 e1965b0cdebe9017c3397c8641147759 JOSE 12705413746 NULL 12705413746 00090 SERINGA DESC 20 ML UN 0.0000 0.5375 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd6f8d6c53ffe9bfd3aa9590ba500cc8 ILDA 12751932542 NULL 12751932542 52010015 Artrodese da Coluna Vertebral Via Posterior 0.0000 498.2200 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 20691 HIDROCORTISONA 100 MG PO IM IV FA 0.0000 2.8300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 20691 HIDROCORTISONA 100 MG PO IM IV FA 0.0000 2.8300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 26981 SORO FISIOLOGICO 0,9% 10 ML SI IV AP 0.0000 0.1400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 26981 SORO FISIOLOGICO 0,9% 10 ML SI IV AP 0.0000 0.1400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 29020166 Nebulização Simples com Broncodilatador 0.0000 1.1700 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 29020166 Nebulização Simples com Broncodilatador 0.0000 2.3400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 29020166 Nebulização Simples com Broncodilatador 0.0000 3.5100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1765 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1765 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1765 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1765 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1765 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1765 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 51241 AGULHA 123X45 0.0000 0.1900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 51241 AGULHA 123X45 0.0000 0.1900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 51659 FENOTEROL 2 MG/ML 10 ML AE IN DS 0.0000 0.2567 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 51659 FENOTEROL 2 MG/ML 10 ML AE IN DS 0.0000 0.2567 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 00090 SERINGA DESC 20 ML UN 0.0000 0.5373 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 00090 SERINGA DESC 20 ML UN 0.0000 0.5373 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 a39fe8b0276da428395df4da4f2b1537 JOSE 12442708440 NULL 12442708440 00098 ABOCATH N 14 A 22 UN 0.0000 3.7700 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 61e4786d45edfdbf19b77fb2c6ce6b9c REINALDO 12754482747 NULL 12754482747 00172 SORO FISIOLOGICO 0,9% 500 ML SI IV BS 0.0000 4.7300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 61e4786d45edfdbf19b77fb2c6ce6b9c REINALDO 12754482747 NULL 12754482747 30010136 Quimioterapia Sistêmica do 2o. ao 7o. Dia Subseqüente na Semana, por Dia de Tratamento 0.0000 0.2500 NULL COBRANCA DE HONORARIOS EM DUPLICIDADE 2607
Glosa Min 2018-10-03 00:00:00.000000 1084117 61e4786d45edfdbf19b77fb2c6ce6b9c REINALDO 12754482747 NULL 12754482747 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 61e4786d45edfdbf19b77fb2c6ce6b9c REINALDO 12754482747 NULL 12754482747 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 61e4786d45edfdbf19b77fb2c6ce6b9c REINALDO 12754482747 NULL 12754482747 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 61e4786d45edfdbf19b77fb2c6ce6b9c REINALDO 12754482747 NULL 12754482747 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 61e4786d45edfdbf19b77fb2c6ce6b9c REINALDO 12754482747 NULL 12754482747 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 61e4786d45edfdbf19b77fb2c6ce6b9c REINALDO 12754482747 NULL 12754482747 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 102001 DIARIA DE APARTAMENTO 0.0000 288.8880 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 102001 DIARIA DE APARTAMENTO 0.0000 288.8900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 102001 DIARIA DE APARTAMENTO 0.0000 288.8900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4072 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4072 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4072 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 51649 ALCOOL ETILICO 70 % ST TP ML 0.0000 0.0600 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 c72cebd9d0b9e675b9c451a2b9dc0207 LUZIA 12708633242 NULL 12708633242 00090 SERINGA DESC 20 ML UN 0.0000 0.5371 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 081fdadb830fb547e83c43fabdb88372 ELZA 12377335349 NULL 12377335349 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 081fdadb830fb547e83c43fabdb88372 ELZA 12377335349 NULL 12377335349 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 081fdadb830fb547e83c43fabdb88372 ELZA 12377335349 NULL 12377335349 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 081fdadb830fb547e83c43fabdb88372 ELZA 12377335349 NULL 12377335349 01611 CLORETO DE POTASSIO 600 MG CA VO UN 0.0000 0.4900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 081fdadb830fb547e83c43fabdb88372 ELZA 12377335349 NULL 12377335349 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 081fdadb830fb547e83c43fabdb88372 ELZA 12377335349 NULL 12377335349 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 081fdadb830fb547e83c43fabdb88372 ELZA 12377335349 NULL 12377335349 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1800 NULL PAGO CONFORME RELATORIO DE AUDITORIA EXTERNA ― CONTA INICIAL 1717
Glosa Min 2018-10-03 00:00:00.000000 1084117 081fdadb830fb547e83c43fabdb88372 ELZA 12377335349 NULL 12377335349 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6860 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6860 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6860 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6860 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 000451 TAXA DE ALIMENTACAO PARA ACOMPANHANTES - 3 REFEICO 0.0000 0.0000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 51379 SERINGA DESC 05 ML UN 0.0000 0.1900 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 51379 SERINGA DESC 05 ML UN 0.0000 0.1900 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 51379 SERINGA DESC 05 ML UN 0.0000 0.1900 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 51379 SERINGA DESC 05 ML UN 0.0000 0.1900 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 51379 SERINGA DESC 05 ML UN 0.0000 0.1900 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 aa7c02a1c41a7519f424396a5c602643 JOAO 12624315048 NULL 12624315048 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 345c226bfea274af1372d41b0305a6c8 ALTINO 12720257940 NULL 12720257940 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 4668d2494ed6c4b2d18be299efcb26a2 JOAO 12469689344 NULL 12469689344 51584 ESPARADRAPO MICROPORE NULL 0.0000 NULL OPME INVALIDO 2201
Glosa Min 2018-10-03 00:00:00.000000 1084117 4668d2494ed6c4b2d18be299efcb26a2 JOAO 12469689344 NULL 12469689344 56261 CLOREXIDINA 2 % ST TP ML DEGERMANTE NULL 0.0000 NULL OPME INVALIDO 2201
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 00069 SERINGA DESC 10 ML UN 0.0000 0.3300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 00090 SERINGA DESC 20 ML UN 0.0000 0.5400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 dd486d36a88cfef0b44fe652638a0164 DELFINA 12660326244 NULL 12660326244 00090 SERINGA DESC 20 ML UN 0.0000 0.5400 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 13812 BOLSA SOL. FISIOLOGICA 0,9% 100 ML SI IV BS 0.0000 3.4100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 01652 TRAMADOL 50 MG CP VO UN 0.0000 1.9300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 01652 TRAMADOL 50 MG CP VO UN 0.0000 1.9300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 01652 TRAMADOL 50 MG CP VO UN 0.0000 1.9300 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 00033 AGULHA DESC 25 X 6 - 25X7 - 25X8 - 26X12 UN 0.0000 0.1000 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 00342 DIPIRONA 500 MG/ML 2 ML SI IM IV AP 0.0000 0.6900 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 35382 COMPRESSAS DE GASES 7.5 X7,5 (11 FIOS ESTERIL) UN 0.0000 0.3000 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.8100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.8100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.0000 0.8100 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 51230 AGULHA DESC 30 X 7 - 40X12 UN 0.0000 0.1800 NULL VALOR DO SERVICO SUPERIOR AO VALOR DE TABELA 1714
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 51588 ESPARADRAPO MICROPORE 50 X 10 CM CM 0.0000 0.7700 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 cf0948b768ab5bb62ad5d1e892021139 ANTONIO 12725005347 NULL 12725005347 51588 ESPARADRAPO MICROPORE 50 X 10 CM CM 0.0000 0.7700 NULL MAT/MED COBRADO EM EXCESSO,NAO PRESCRITO OU 0306
Glosa Min 2018-10-03 00:00:00.000000 1084117 610c198ec4c064687cf0524f147d3aed ROBERTO 12748814743 NULL 12748814743 16322 BENZILPENICILINA POTASSICA CRIST. 5.000.000 8.0700 8.0683 0.0017 ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 51378 SERINGA DESC 03 ML UN 0.1500 0.0600 0.0900 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 51378 SERINGA DESC 03 ML UN 0.1500 0.0600 0.0900 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 53932 ALPRAZOLAM 0,25 MG CP VO UN 0.2600 0.1100 0.1500 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00091 SERINGA DESC 01 ML (INSULINA) UN 0.3100 0.1300 0.1800 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00127 LUVA DE PROCEDIMENTO UNIDADE UN 0.3300 0.1300 0.2000 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 00127 LUVA DE PROCEDIMENTO UNIDADE UN 0.3300 0.1300 0.2000 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.4000 0.1600 0.2400 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.4000 0.1600 0.2400 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.4000 0.1600 0.2400 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.4000 0.1600 0.2400 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.4000 0.1600 0.2400 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.4000 0.1600 0.2400 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.4000 0.1600 0.2400 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.4000 0.1600 0.2400 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 51162 AGUA BIDESTILADA 10 ML SI IM IV AP 0.4000 0.1600 0.2400 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 54687 IODOPOVIDONA SD TP ML 0.4000 0.1600 0.2400 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 880e253fcba3461dbf3e0fdc52428cce DIVINA 12633927040 NULL 12633927040 07802 PIPERACILINA 4 G + TAZOBACTAM 500 MG PO IV FA 83.4500 32.5900 50.8600 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 01081197 5125859e8d2860b83822c41756a9b5bf ESMERALDA 12734516820 NULL 12734516820... 203001 TAXA DE BOX HORA 1 CICLO 0.0000 0.0000 NULL TAXA / ALUGUEL INVALIDO 2401
Glosa Min 2018-10-03 00:00:00.000000 01081197 e0b1f77dc9cff210f2fbead99c7ba4d4 MARCIO 12790052920 NULL 12790052920 00171 SORO FISIOLOGICO 0,9% 250 ML SI IV BS NULL 0.0000 NULL OPME INVALIDO 2201
Glosa Min 2018-10-03 00:00:00.000000 1084117 16b1e9f62f247f02ad5cac910ee15b4e BERCHOLINA 12631612848 NULL 12631612848 00171 SORO FISIOLOGICO 0,9% 250 ML SI IV BS 3.9400 3.7600 0.1800 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 16b1e9f62f247f02ad5cac910ee15b4e BERCHOLINA 12631612848 NULL 12631612848 04073 TRAMADOL 50 MG 1 ML SI IM IV AP 4.1900 4.0000 0.1900 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 16b1e9f62f247f02ad5cac910ee15b4e BERCHOLINA 12631612848 NULL 12631612848 04073 TRAMADOL 50 MG 1 ML SI IM IV AP 4.1900 4.0000 0.1900 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 16b1e9f62f247f02ad5cac910ee15b4e BERCHOLINA 12631612848 NULL 12631612848 04073 TRAMADOL 50 MG 1 ML SI IM IV AP 4.1900 4.0000 0.1900 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 16b1e9f62f247f02ad5cac910ee15b4e BERCHOLINA 12631612848 NULL 12631612848 04073 TRAMADOL 50 MG 1 ML SI IM IV AP 4.1900 3.9900 0.2000 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 16b1e9f62f247f02ad5cac910ee15b4e BERCHOLINA 12631612848 NULL 12631612848 04073 TRAMADOL 50 MG 1 ML SI IM IV AP 4.1900 3.9900 0.2000 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 16b1e9f62f247f02ad5cac910ee15b4e BERCHOLINA 12631612848 NULL 12631612848 04073 TRAMADOL 50 MG 1 ML SI IM IV AP 4.1900 3.9900 0.2000 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 16b1e9f62f247f02ad5cac910ee15b4e BERCHOLINA 12631612848 NULL 12631612848 22421 PIPERACILINA 2 G + TAZOBACTAM 250 MG 30 ML PO IV 55.3400 52.7400 2.6000 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 16b1e9f62f247f02ad5cac910ee15b4e BERCHOLINA 12631612848 NULL 12631612848 22421 PIPERACILINA 2 G + TAZOBACTAM 250 MG 30 ML PO IV 55.3400 52.7400 2.6000 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 16b1e9f62f247f02ad5cac910ee15b4e BERCHOLINA 12631612848 NULL 12631612848 22421 PIPERACILINA 2 G + TAZOBACTAM 250 MG 30 ML PO IV 55.3400 52.7400 2.6000 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 16b1e9f62f247f02ad5cac910ee15b4e BERCHOLINA 12631612848 NULL 12631612848 22421 PIPERACILINA 2 G + TAZOBACTAM 250 MG 30 ML PO IV 55.3400 52.7400 2.6000 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 16b1e9f62f247f02ad5cac910ee15b4e BERCHOLINA 12631612848 NULL 12631612848 22421 PIPERACILINA 2 G + TAZOBACTAM 250 MG 30 ML PO IV 55.3400 52.7400 2.6000 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 16b1e9f62f247f02ad5cac910ee15b4e BERCHOLINA 12631612848 NULL 12631612848 20080 LINEZOLIDA 2 MG/ML 300 ML SI IV BS 174.9800 166.7800 8.2000 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 1084117 16b1e9f62f247f02ad5cac910ee15b4e BERCHOLINA 12631612848 NULL 12631612848 20080 LINEZOLIDA 2 MG/ML 300 ML SI IV BS 174.9800 166.7800 8.2000 ITEM GLOSADO POR RATEIO E SEM JUSTIFICATIVA DO CONVENIO 7701
Glosa Min 2018-10-03 00:00:00.000000 01081195 335f5319bf8629a6efcb92037294fea8 JOSE 12820840018 NULL 12820840018 00010014 CONSULTA EM CONSULTORIO MEDICO 0.0000 50.0000 NULL ITEM GLOSADO SEM JUSTIFICATIVA DO CONVENIO 7700